[Congressional Bills 107th Congress]
[From the U.S. Government Publishing Office]
[S. 2649 Reported in Senate (RS)]






                                                       Calendar No. 484
107th CONGRESS
  2d Session
                                S. 2649

  To provide assistance to combat the HIV/AIDS pandemic in developing 
                           foreign countries.


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

                             June 19, 2002

  Mr. Kennedy (for himself, Mr. Frist, Mrs. Clinton, Mr. DeWine, Mr. 
  Daschle, Mr. Santorum, Mr. Corzine, Mrs. Murray, Mr. Bingaman, Mr. 
Dodd, Mr. Durbin, Mrs. Feinstein, Mr. Jeffords, Mr. Reed, Mr. Edwards, 
Mr. Harkin, and Ms. Mikulski) introduced the following bill; which was 
 read twice and referred to the Committee on Health, Education, Labor, 
                              and Pensions

                              July 3, 2002

  Reported under the authority of the order of the Senate of June 26, 
                2002, by Mr. Kennedy, with an amendment
 [Strike out all after the enacting clause and insert the part printed 
                               in italic]

_______________________________________________________________________

                                 A BILL


 
  To provide assistance to combat the HIV/AIDS pandemic in developing 
                           foreign countries.

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

<DELETED>SECTION 1. SHORT TITLE.</DELETED>

<DELETED>    This Act may be cited as the ``International AIDS 
Treatment and Prevention Act of 2002''.</DELETED>

<DELETED>SEC. 2. AUTHORITY OF THE DEPARTMENT OF HEALTH AND HUMAN 
              SERVICES.</DELETED>

<DELETED>    (a) In General.--Title III of the Public Health Service 
Act (42 U.S.C. 241 et seq.) is amended by adding at the end the 
following:</DELETED>

     <DELETED>``PART P--HIV/AIDS PREVENTION, CARE AND TREATMENT IN 
                     DEVELOPING COUNTRIES</DELETED>

<DELETED>``SEC. 399AA. GENERAL AUTHORITY OF THE CENTERS FOR DISEASE 
              CONTROL AND PREVENTION.</DELETED>

<DELETED>    ``(a) Purpose.--It is the purpose of this section to 
provide the Secretary, acting through the Director of the Centers for 
Disease Control and Prevention, with the authority to carry out HIV/
AIDS prevention, care, treatment, support, capacity development and 
other activities (determined appropriate by the Secretary) in countries 
with or at risk for severe HIV epidemic with particular attention to 
resource constrained countries, as determined by the 
Secretary.</DELETED>
<DELETED>    ``(b) Activities and Assistance.--In carrying out the 
purpose described in subsection (a), the Secretary, acting through the 
Director of the Centers for Disease Control and Prevention, in 
consultation with the Administrator of the United States Agency for 
International Development and the Administrator of the Health Resources 
and Services Administration, may provide support and assistance under 
this section relating to--</DELETED>
        <DELETED>    ``(1) HIV prevention services provided through--
        </DELETED>
                <DELETED>    ``(A) education and voluntary counseling 
                and testing activities, including rapid testing, the 
                development and application of confidentiality 
                protections with respect to such counseling and 
                testing, and the integration of such activities into 
                programs serving women and children;</DELETED>
                <DELETED>    ``(B) programs to reduce the mother-to-
                child transmission of HIV, including the involvement of 
                fathers in such programs;</DELETED>
                <DELETED>    ``(C) activities involving behavioral 
                interventions for youth, women, and other vulnerable 
                groups;</DELETED>
                <DELETED>    ``(D) programs to prevent the transmission 
                of HIV and other pathogens at health care facilities 
                (including the use of universal precautions, equipment 
                sterilization, post-exposure prophylaxis for health 
                care workers and other individuals determined to be 
                appropriate, and other interventions appropriate to the 
                resources available), and to support the use of post 
                exposure prophylaxis, when indicated, for 
                patients;</DELETED>
                <DELETED>    ``(E) activities to ensure a safe blood 
                supply;</DELETED>
                <DELETED>    ``(F) programs to provide prevention, 
                care, treatment, and patient management services for 
                sexually transmitted infections to infected individuals 
                and individuals at risk of infection; and</DELETED>
                <DELETED>    ``(G) activities, including laboratory 
                support, to collect and maintain accurate HIV/AIDS 
                surveillance and epidemiologic data, to target and 
                monitor programs, and to measure the effectiveness of 
                interventions;</DELETED>
        <DELETED>    ``(2) HIV/AIDS care and treatment services 
        provided through--</DELETED>
                <DELETED>    ``(A) programs to provide care and 
                treatment, integrated with prevention services to 
                further reduce the transmission of HIV, for individuals 
                living with HIV/AIDS, including the treatment of 
                opportunistic infections (including tuberculosis) and 
                the provision of antiretroviral therapies and 
                nutritional services;</DELETED>
                <DELETED>    ``(B) programs to provide support services 
                that are needed to enhance the effectiveness of health 
                services and to promote family stability, including 
                services for family members affected by, but not 
                infected with, HIV such as children orphaned by AIDS; 
                and</DELETED>
                <DELETED>    ``(C) programs that link care and 
                treatment services to proven prevention programs, 
                including linkages with voluntary counseling and 
                testing efforts (including rapid testing);</DELETED>
        <DELETED>    ``(3) infrastructure and training through--
        </DELETED>
                <DELETED>    ``(A) activities to improve the health 
                infrastructure and institutional capacity within 
                participating countries, including the training of 
                appropriate personnel, and to assist such countries in 
                expanding and improving the availability of health care 
                facilities, to enable such countries to develop and 
                manage HIV/AIDS education, prevention, care and 
                treatment programs and to conduct evaluations of such 
                programs; and</DELETED>
                <DELETED>    ``(B) activities to provide laboratory 
                support as well as technical assistance and training to 
                increase the capacity for the diagnosis, care, and 
                treatment of HIV/AIDS and related health conditions 
                (including rapid testing);</DELETED>
        <DELETED>    ``(4) HIV/AIDS treatment protocols through--
        </DELETED>
                <DELETED>    ``(A) the provision of support and 
                assistance to participating countries for the 
                development of treatment protocols for the delivery of 
                HIV/AIDS treatment and prevention services; 
                and</DELETED>
                <DELETED>    ``(B) the provision of assistance to 
                participating countries determined to be ready to 
                implement the protocols described in subparagraph (A); 
                and</DELETED>
        <DELETED>    ``(5) other activities determined appropriate by 
        the Secretary.</DELETED>
<DELETED>    ``(c) Utilization of Existing Capacities.--In carrying out 
activities under subsection (b), the Secretary, acting through the 
Director of the Centers for Disease Control and Prevention and in 
consultation with the Administrator of the United States Agency for 
International Development and the Administrator of the Health Resources 
and Services Administration, shall, to the maximum extent practicable, 
utilize existing indigenous capacity in developing countries, including 
coordinating with relevant government ministries and carrying out 
activities in partnership with non-governmental organizations and 
affected communities.</DELETED>
<DELETED>    ``(d) Health Resources and Services Administration.--In 
carrying out activities under paragraphs (2) and (3) of subsection (b), 
the Secretary, acting through the Director of the Centers for Disease 
Control and Prevention, shall enter into interagency agreements, 
monetary transfers, and contracts with the Administrator of the Health 
Resources and Services Administration to ensure that such activities 
benefit from the specialized expertise of such Administration related 
to the assessment of needs as well as the development and 
implementation of community-based systems of care and appropriate 
infrastructure, including the training of health care providers and 
community workers.</DELETED>
<DELETED>    ``(e) Blood Supply.--In carrying out activities under 
subsection (b)(1)(E), the Secretary, acting through the Director of the 
Centers for Disease Control and Prevention, shall assist participating 
countries in developing national, regional, or local systems to--
</DELETED>
        <DELETED>    ``(1) monitor, manage, and test the blood supply 
        to ensure that such supply is screened for HIV;</DELETED>
        <DELETED>    ``(2) increase recruitment and retention of 
        appropriate blood donors; and</DELETED>
        <DELETED>    ``(3) provide for technology transfer and capacity 
        building in proven best blood safety practices appropriate to 
        local conditions.</DELETED>
<DELETED>    ``(f) Authorization of Appropriations.--There is 
authorized to be appropriated to carry out this section, $400,000,000 
for fiscal year 2003, and such sums as may be necessary for fiscal year 
2004. Of the amount appropriated under the preceding sentence for each 
fiscal year, the Secretary shall make available $30,000,000 in fiscal 
year 2003 and $45,000,000 in fiscal year 2004 to carry out subsection 
(b)(2)(A) and section 399DD. Amounts appropriated under this subsection 
shall remain available until expended.</DELETED>

<DELETED>``SEC. 399BB. GENERAL AUTHORITY OF THE HEALTH RESOURCES AND 
              SERVICES ADMINISTRATION.</DELETED>

<DELETED>    ``(a) Purpose.--It is the purpose of this section to 
provide the Secretary, acting through the Administrator of the Health 
Resources and Services Administration, with the authority to carry out 
HIV/AIDS care, treatment, capacity development and other activities 
(determined appropriate by the Secretary) in countries with or at risk 
for severe HIV epidemic with particular attention to resource 
constrained countries, as determined by the Secretary.</DELETED>
<DELETED>    ``(b) Activities and Assistance.--In carrying out the 
purpose described in subsection (a), the Secretary, acting through the 
Administrator of the Health Resources and Services Administration, in 
consultation with the Director of the Centers for Disease Control and 
Prevention and the Administrator of the United States Agency for 
International Development, may provide assistance under this section 
relating to--</DELETED>
        <DELETED>    ``(1) activities to assist communities in 
        assessing the strengths and capabilities of the existing system 
        of care and treatment relating to HIV/AIDS and other 
        opportunistic infections, including critical unmet 
        needs;</DELETED>
        <DELETED>    ``(2) activities to assist communities in the 
        development and implementation of appropriate systems of care 
        that provide for a continuum of HIV/AIDS-related services for 
        prevention, treatment, palliative care, and hospice services 
        based on an assessment under paragraph (1);</DELETED>
        <DELETED>    ``(3) activities to improve the health-related 
        infrastructure and institutional capacity of participating 
        countries, including the training of health care providers and 
        community workers, to enable such countries to develop and 
        manage HIV/AIDS education, prevention, care and treatment 
        programs and to conduct evaluations of such programs;</DELETED>
        <DELETED>    ``(4) activities to assist in the development of 
        training modules and curricula on HIV/AIDS and associated 
        conditions as part of the professional training programs for 
        physicians, nurses, dentists, pharmacists, and other health 
        care providers; and</DELETED>
        <DELETED>    ``(5) other activities determined appropriate by 
        the Secretary.</DELETED>
<DELETED>    ``(c) Utilization of Existing Capacities.--In carrying out 
activities under subsection (b), the Secretary, acting through the 
Administrator of the Health Resources and Services Administration and 
in consultation with the Director of the Centers for Disease Control 
and Prevention and the Administrator of the United States Agency for 
International Development, shall, to the maximum extent practicable, 
utilize existing indigenous capacity in participating countries, 
including coordinating with relevant government ministries and carrying 
out activities in partnership with non-governmental organizations and 
affected communities.</DELETED>
<DELETED>    ``(d) Authorization of Appropriations.--There is 
authorized to be appropriated to carry out this section, $40,000,000 
for fiscal year 2003, and such sums as may be necessary for fiscal year 
2004. Amounts appropriated under this subsection shall remain available 
until expended.</DELETED>

<DELETED>``SEC. 399CC. HIV/AIDS TRAINING PARTNERSHIP.</DELETED>

<DELETED>    ``(a) In General.--The Secretary, acting through the 
Director of the National Institutes of Health and in coordination with 
the Administrator of the Health Resources and Services Administration, 
shall award supplemental grants to eligible entities to enable such 
entities to provide support for clinical education and training in the 
delivery of HIV/AIDS care and treatment services.</DELETED>
<DELETED>    ``(b) Eligible Entities.--To be eligible to receive a 
supplemental grant under subsection (a), an entity shall--</DELETED>
        <DELETED>    ``(1) be a recipient of an international HIV/AIDS 
        clinical research, education, or training grant awarded by the 
        National Institutes of Health;</DELETED>
        <DELETED>    ``(2) provide assurances to the Secretary that the 
        entity has developed a partnership with a hospital-based or 
        community-based health care entity in the host country for the 
        purpose of providing services under each grant; and</DELETED>
        <DELETED>    ``(3) prepare and submit to the Secretary an 
        application at such time, in such manner, and containing such 
        information as the Secretary may require, including a 
        description of the activities to be carried out with amounts 
        received under the grant.</DELETED>
<DELETED>    ``(c) Use of Funds.--An entity shall use amounts received 
under a supplemental grant under subsection (a) to provide clinical 
education and training in the delivery of HIV/AIDS care and treatment 
services. Such education and training shall be designed to develop 
health care provider capacity to deliver HIV/AIDS care and treatment 
services in a variety of institutional and community-based 
settings.</DELETED>
<DELETED>    ``(d) Priority.--In awarding grants under subsection (a), 
the Director of the National Institutes of Health shall give priority 
to applicants that will carry out activities that assess existing 
provider capacity and address the training needs of a range of health 
care providers (from physicians to nurses to other health care 
providers).</DELETED>
<DELETED>    ``(e) Authorization of Appropriations.--There is 
authorized to be appropriated to carry out this section, $50,000,000 
for fiscal year 2003, and such sums as may be necessary for fiscal year 
2004. Amounts appropriated under this subsection shall remain available 
until expended.</DELETED>

<DELETED>``SEC. 399DD. FAMILY SURVIVAL PARTNERSHIPS.</DELETED>

<DELETED>    ``(a) Purpose.--The purpose of this section is to provide 
support, through a public-private partnership, for the provision of 
medical care and support services to HIV positive parents and their 
children identified through existing programs to prevent mother-to-
child transmission of HIV in countries with or at risk for severe HIV 
epidemic with particular attention to resource constrained countries, 
as determined by the Secretary.</DELETED>
<DELETED>    ``(b) Grants.--</DELETED>
        <DELETED>    ``(1) In general.--The Secretary, acting through 
        the Director of the Centers for Disease Control and Prevention, 
        is authorized to award a grant to an eligible administrative 
        organization to enable the organization to award subgrants to 
        eligible entities to expand activities to prevent the mother-
        to-child transmission of HIV by providing medical care and 
        support services to HIV infected parents and their 
        children.</DELETED>
        <DELETED>    ``(2) Administrative organization.--To be eligible 
        to receive a grant under paragraph (1), an administrative 
        organization shall--</DELETED>
                <DELETED>    ``(A) have a demonstrable record in 
                managing large scale maternal and child health programs 
                in countries with or at risk for severe HIV epidemic 
                with particular attention to resource constrained 
                countries, as determined by the Secretary, and 
                sufficient HIV/AIDS expertise;</DELETED>
                <DELETED>    ``(B) have established relationships with 
                major international organizations and multilateral 
                institutions;</DELETED>
                <DELETED>    ``(C) provide an assurance to the 
                Secretary that the organization will contribute (either 
                directly or through private sector financial support) 
                non-Federal funds to the costs of the activities to be 
                carried out under this section in an amount that is not 
                less than the amount of funds provided to the 
                organization under a grant this section; and</DELETED>
                <DELETED>    ``(D) prepare and submit an application to 
                the Secretary at such time, in such manner, and 
                accompanied by such information as the Secretary may 
                require.</DELETED>
        <DELETED>    ``(3) Use of funds.--Amounts provided under a 
        grant awarded under paragraph (1) shall be used--</DELETED>
                <DELETED>    ``(A) to award subgrants to eligible 
                entities to enable such entities to carry out 
                activities described in subsection (c);</DELETED>
                <DELETED>    ``(B) for administrative support and 
                subgrant management;</DELETED>
                <DELETED>    ``(C) for administrative data collection 
                and reporting concerning grant activities;</DELETED>
                <DELETED>    ``(D) for the monitoring and evaluation of 
                grant activities;</DELETED>
                <DELETED>    ``(E) for training and technical 
                assistance for subgrantees; and</DELETED>
                <DELETED>    ``(F) to promote sustainability.</DELETED>
<DELETED>    ``(c) Subgrants.--</DELETED>
        <DELETED>    ``(1) In general.--An organization awarded a grant 
        under subsection (b) shall use amounts received under the grant 
        to award subgrants to eligible entities.</DELETED>
        <DELETED>    ``(2) Eligibility.--To be eligible to receive a 
        subgrant under paragraph (1), an entity shall--</DELETED>
                <DELETED>    ``(A) be a local health organization, an 
                international organization, or a partnership of such 
                organizations;</DELETED>
                <DELETED>    ``(B) demonstrate to the awarding 
                organization that such entity--</DELETED>
                        <DELETED>    ``(i) is currently administering a 
                        proven intervention to prevent mother-to-child 
                        transmission of HIV in countries with or at 
                        risk for severe HIV epidemic with particular 
                        attention to resource constrained countries, as 
                        determined by the Secretary;</DELETED>
                        <DELETED>    ``(ii) serves a catchment area 
                        with a minimum HIV seroprevalence of 3 percent 
                        in pregnant women;</DELETED>
                        <DELETED>    ``(iii) has demonstrated support 
                        for the proposed program from relevant 
                        government entities;</DELETED>
                        <DELETED>    ``(iv) is able to provide HIV 
                        care, including antiretroviral treatment when 
                        medically indicated, to HIV positive women, 
                        men, and children with the support of the 
                        project funding; and</DELETED>
                        <DELETED>    ``(v) has the ability to enroll a 
                        minimum of 250 HIV infected women per service 
                        site, based on the current uptake rate, into 
                        existing HIV mother-to-child transmission 
                        programs; and</DELETED>
                <DELETED>    ``(C) prepare and submit to the awarding 
                organization an application at such time, in such 
                manner, and containing such information as the 
                organization may require.</DELETED>
        <DELETED>    ``(3) Local health and international 
        organizations.--For purposes of paragraph (2)(A)--</DELETED>
                <DELETED>    ``(A) the term `local health organization' 
                means a public sector health system, non-governmental 
                organization, institution of higher education, 
                community-based organization, or non-profit health 
                system that provides directly, or has a clear link with 
                a provider for the indirect provision of, primary 
                health care services; and</DELETED>
                <DELETED>    ``(B) the term `international 
                organization' means--</DELETED>
                        <DELETED>    ``(i) a non-profit international 
                        entity;</DELETED>
                        <DELETED>    ``(ii) an international charitable 
                        institution;</DELETED>
                        <DELETED>    ``(iii) a private voluntary 
                        international entity; or</DELETED>
                        <DELETED>    ``(iv) a multilateral 
                        institution.</DELETED>
        <DELETED>    ``(4) Selection of subgrant recipients.--In 
        awarding subgrants under this subsection, the organization 
        shall--</DELETED>
                <DELETED>    ``(A) consider applicants from a range of 
                health care settings, program approaches, and 
                geographic locations; and</DELETED>
                <DELETED>    ``(B) if appropriate, award not less than 
                1 grant to an applicant to fund a national system of 
                health care delivery to HIV positive 
                families.</DELETED>
        <DELETED>    ``(5) Use of subgrant funds.--An eligible entity 
        awarded a subgrant under this subsection shall use subgrant 
        funds to expand activities to prevent mother-to-child 
        transmission of HIV by providing medical care and support 
        services to parents and their children, including--</DELETED>
                <DELETED>    ``(A) the hiring and training of local 
                personnel, including physicians, nurses, other health 
                care providers, counselors, social workers, outreach 
                personnel, laboratory technicians, data managers, and 
                administrative support personnel;</DELETED>
                <DELETED>    ``(B) paying laboratory costs, including 
                costs related to necessary equipment and diagnostic 
                testing and monitoring (including rapid testing), 
                complete blood counts, standard chemistries, and liver 
                function testing for infants, children, and parents, 
                and costs related to the purchase of necessary 
                laboratory equipment;</DELETED>
                <DELETED>    ``(C) purchasing pharmaceuticals for HIV-
                related conditions, including antiretroviral 
                therapies;</DELETED>
                <DELETED>    ``(D) funding support services including 
                adherence and psychosocial support services;</DELETED>
                <DELETED>    ``(E) operational support activities; 
                and</DELETED>
                <DELETED>    ``(F) conducting community outreach and 
                capacity building activities, including activities to 
                raise the awareness of individuals of the program 
                carried out by the subgrantee, other communications 
                activities in support of the program, local advisory 
                board functions, and transportation necessary to ensure 
                program participation.</DELETED>
<DELETED>    ``(d) Reports.--Not later than 6 months after the date of 
enactment of this section, and annually thereafter, an administrative 
organization awarded a grant under subsection (b)(1) shall submit to 
the Secretary and the appropriate committees of Congress, a report that 
includes--</DELETED>
                <DELETED>    ``(A) the progress of programs funded 
                under this section;</DELETED>
                <DELETED>    ``(B) the benchmarks of success of 
                programs funded under this section; and</DELETED>
                <DELETED>    ``(C) recommendations of how best to 
                proceed with the programs funded under this section 
                upon the expiration of funding under subsection 
                (e).</DELETED>
<DELETED>    ``(e) Funding.--In making amounts available under section 
399AA(f) to carry out this section, the Secretary shall ensure that not 
less than--</DELETED>
        <DELETED>    ``(1) $45,000,000 is made available to carry out 
        this section for fiscal year 2003; and</DELETED>
        <DELETED>    ``(2) $30,000,000 is made available to carry out 
        this section for fiscal year 2004.</DELETED>
<DELETED>    ``(f) Limitation on Administrative Expenses.--An 
administrative organization shall ensure that not more than 12 percent 
of the amount of a grant received under this section by the 
organization is used for the administrative activities described in 
subparagraphs (B), (C), (D), and (E) of subsection (b)(3) and 
subsection (b)(5)(E).</DELETED>

<DELETED>``SEC. 399EE. INTRA-AGENCY COORDINATION OF GLOBAL HIV/AIDS 
              INITIATIVES.</DELETED>

<DELETED>    ``(a) In General.--The Secretary, acting through the 
Director of the Office of International Affairs (referred to in this 
section as the `Director') of the Department of Health and Human 
Services (referred to in this section as the `Department'), shall 
ensure--</DELETED>
        <DELETED>    ``(1) the coordination of all Department programs 
        related to the prevention, treatment, and monitoring of HIV/
        AIDS in countries with or at risk for severe HIV epidemic with 
        particular attention to resource constrained countries, as 
        determined by the Secretary (referred to in this section as 
        `Department programs'); and</DELETED>
        <DELETED>    ``(2) that global HIV/AIDS activities are 
        conducted in a coordinated, strategic fashion, utilizing the 
        expertise from the various agencies within the Department, to 
        the maximum extent practicable.</DELETED>
<DELETED>    ``(b) Duties.--In carrying out this section, the Secretary 
shall--</DELETED>
        <DELETED>    ``(1) review all Departmental programs to ensure 
        proper coordination and compatibility of the activities, 
        strategies, and policies of such programs; and</DELETED>
        <DELETED>    ``(2) ensure that the Departmental programs 
        utilize the best possible practices for HIV/AIDS prevention, 
        treatment, and monitoring to improve the effectiveness of 
        Department programs in countries in which the Department 
        operates.</DELETED>
<DELETED>    ``(c) Report.--</DELETED>
        <DELETED>    ``(1) In general.--The Director shall prepare an 
        annual report that--</DELETED>
                <DELETED>    ``(A) describes the actions that are being 
                taken to coordinate the multiple roles and policies of, 
                and foster collaboration among, the offices and 
                agencies of the Department that contribute to global 
                HIV/AIDS activities;</DELETED>
                <DELETED>    ``(B) describes the respective roles and 
                activities of each of the offices and agencies of the 
                Department;</DELETED>
                <DELETED>    ``(C) contains any recommendations for 
                legislative and funding actions that are needed to 
                create a coherent, effective departmental approach to 
                global HIV/AIDS that achieves the goals for Department 
                programs; and</DELETED>
                <DELETED>    ``(D) describes the progress made towards 
                meeting the HIV/AIDS goals and outcomes as identified 
                by the Director.</DELETED>
        <DELETED>    ``(2) Submission to congress.--Not later than 1 
        year after the date of enactment of this part, and annually 
        thereafter, the Secretary shall submit the report described in 
        paragraph (1) to the appropriate committees of 
        Congress.''.</DELETED>
<DELETED>    (b) Extension of Tuberculosis Prevention Program.--Section 
317E(g) of the Public Health Service Act (42 U.S.C. 247b-6(g)) is 
amended--</DELETED>
        <DELETED>    (1) in paragraph (1)(A), by striking ``2002'' and 
        inserting ``2004'';</DELETED>
        <DELETED>    (2) in paragraph (2), by striking ``2002'' and 
        inserting ``2004''; and</DELETED>
        <DELETED>    (3) by adding at the end the following:</DELETED>
        <DELETED>    ``(3) Coordination.--Activities under this section 
        shall, to the extent practicable, be coordinated with related 
        activities carried out under the International AIDS Treatment 
        and Prevention Act of 2002 (and the amendments made by that 
        Act).''.</DELETED>

<DELETED>SEC. 3. MICROBICIDE RESEARCH AT THE NATIONAL INSTITUTES OF 
              HEALTH.</DELETED>

<DELETED>    Subpart I of part D of title XXIII of the Public Health 
Service Act (42 U.S.C. 300cc-40 et seq.) is amended by inserting after 
section 2351 the following:</DELETED>

<DELETED>``SEC. 2351A. MICROBICIDES FOR PREVENTING TRANSMISSION OF HIV 
              AND OTHER SEXUALLY TRANSMITTED INFECTIONS.</DELETED>

<DELETED>    ``(a) Expansion and Coordination of Activities.--The 
Secretary, acting through the Director of the Office of AIDS Research 
and in coordination with other relevant institutes and offices, shall 
expand, intensify, and coordinate the activities of all appropriate 
institutes and components of the National Institutes of Health with 
respect to research on the development of microbicides to prevent the 
transmission of HIV and other sexually transmitted infections (in this 
section referred to as `microbicide research').</DELETED>
<DELETED>    ``(b) Research Plan.--The Secretary, acting through the 
Director of the Office of AIDS Research and in consultation with the 
Director of the Institute of Allergy and Infectious Diseases, shall 
expedite the implementation of the strategic plan for the conduct and 
support of microbicide research, and shall annually review and as 
appropriate revise the plan. In developing, implementing, and reviewing 
the plan, the Director of the Office of AIDS Research shall consult 
with the heads of other Federal agencies, including the Director of the 
Centers for Disease Control and Prevention and the Administrator of the 
United States Agency for International Development, involved in 
microbicide research, with the microbicide research community, and with 
health advocates.</DELETED>
<DELETED>    ``(c) Microbicide Research and Development Teams.--
</DELETED>
        <DELETED>    ``(1) In general.--The Secretary, acting through 
        the Director of the National Institutes of Health, shall award 
        grants or contracts to public and private entities for the 
        development and operation of multidisciplinary teams to conduct 
        research on innovative microbicide concepts, including 
        combination microbicides.</DELETED>
        <DELETED>    ``(2) Peer review requirement.--The Director shall 
        award a grant or contract to an entity under paragraph (1) only 
        if the grant or contract has been recommended after technical 
        and scientific peer review in accordance with regulations under 
        section 492.</DELETED>
<DELETED>    ``(d) Report.--Not later than 1 year after the date of the 
initial submission of the research plan under subsection (b), and 
annually thereafter, the Secretary, acting through the Director of the 
Office of AIDS Research and in consultation with the Director of the 
Institute of Allergy and Infectious Diseases, shall submit to the 
Committee on Energy and Commerce and the Committee on Appropriations of 
the House of Representatives and the Committee on Health, Education, 
Labor, and Pensions and the Committee on Appropriations of the Senate a 
report that describes the activities of the National Institutes of 
Health regarding microbicide research. Each such report shall include--
</DELETED>
        <DELETED>    ``(1) an updated research plan;</DELETED>
        <DELETED>    ``(2) a description and evaluation of the progress 
        made, during the period for which such report is prepared, in 
        research on microbicides;</DELETED>
        <DELETED>    ``(3) a summary and analysis of expenditures made, 
        during the period for which the report is made, for activities 
        with respect to microbicides research conducted and supported 
        by the National Institutes of Health, including the number of 
        full-time equivalent employees; and</DELETED>
        <DELETED>    ``(4) recommendations as the Director of the 
        Office of AIDS Research considers appropriate.</DELETED>
<DELETED>    ``(f) Definition.--In this section, the term `HIV' means 
the human immunodeficiency virus. Such term includes acquired immune 
deficiency syndrome.''.</DELETED>

<DELETED>SEC. 4. AUTHORITY OF THE DEPARTMENT OF LABOR.</DELETED>

<DELETED>    (a) Purpose.--It is the purpose of this section to provide 
the Secretary of Labor with the authority to carry out workplace-based 
HIV/AIDS programs in countries with or at risk for severe HIV epidemic 
with particular attention to resource constrained countries, as 
determined by the Secretary.</DELETED>
<DELETED>    (b) Activities and Assistance.--In carrying out the 
purpose described in subsection (a), the Secretary of Labor, in 
consultation with the Administrator of the United States Agency for 
International Development, may provide assistance under this section 
relating to--</DELETED>
        <DELETED>    (1) the establishment and implementation of 
        workplace HIV/AIDS prevention and education programs in 
        countries with or at risk for severe HIV epidemic with 
        particular attention to resource constrained countries, as 
        determined by the Secretary, including programs that emphasize 
        protections against discrimination and the creation of 
        supportive environments for individuals living with HIV/
        AIDS;</DELETED>
        <DELETED>    (2) the development and implementation of on-site 
        care and wellness programs that enhance the health and 
        productivity of the workforce in countries with or at risk for 
        severe HIV epidemic with particular attention to resource 
        constrained countries, as determined by the 
        Secretary;</DELETED>
        <DELETED>    (3) activities to strengthen collaboration among 
        governments, business, and labor leaders to respond to the HIV/
        AIDS pandemic; and</DELETED>
        <DELETED>    (4) other activities determined appropriate by the 
        Secretary.</DELETED>
<DELETED>    (c) Authorization of Appropriations.--There is authorized 
to be appropriated to carry out this section, $10,000,000 for fiscal 
year 2003, and such sums as may be necessary for fiscal year 2004. 
Amounts appropriated under this subsection shall remain available until 
expended.</DELETED>

<DELETED>SEC. 5. AUTHORITY FOR INTERNATIONAL PROGRAMS.</DELETED>

<DELETED>    Section 307 of the Public Health Service Act (42 U.S.C. 
242l) is amended--</DELETED>
        <DELETED>    (1) in subsection (b)--</DELETED>
                <DELETED>    (A) in paragraph (6), by adding ``and'' at 
                the end;</DELETED>
                <DELETED>    (B) in paragraph (7), by striking ``; 
                and'' and inserting a period;</DELETED>
                <DELETED>    (C) in the flush sentence after paragraph 
                (7), by inserting ``new'' before ``facility in any 
                foreign country''; and</DELETED>
                <DELETED>    (D) by striking paragraph (8); 
                and</DELETED>
        <DELETED>    (2) by adding at the end the following:</DELETED>
<DELETED>    ``(d)(1) The Secretary is authorized to utilize the 
authority contained in section 2 of the State Department Basic 
Authorities Act of 1956 (22 U.S.C. 2669), subject to the limitations 
set forth in subsection (e).</DELETED>
<DELETED>    ``(2) The Secretary is authorized to use the authority 
contained in section 1 of the Act of April 18, 1930 (46 Stat. 177; 22 
U.S.C. 291) and section 1 of the Foreign Service Buildings Act (22 
U.S.C. 292) directly or through contract, grant, or cooperative 
agreement to lease, alter, or renovate facilities in foreign countries 
as necessary to conduct programs of assistance for international health 
activities, including activities relating to HIV/AIDS and other 
infectious diseases, chronic and environmental diseases, and other 
health activities abroad.</DELETED>
<DELETED>    ``(e) In exercising the authority set forth in paragraphs 
(1) and (2) of subsection (d), the Secretary shall consult with the 
Secretary of State to ensure that planned activities are within the 
legal strictures of the State Department Basic Authorities Act of 1956 
and other applicable laws.''.</DELETED>

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``International AIDS Treatment and 
Prevention Act of 2002''.

SEC. 2. AUTHORITY OF THE DEPARTMENT OF HEALTH AND HUMAN SERVICES.

    (a) In General.--Title III of the Public Health Service Act (42 
U.S.C. 241 et seq.) is amended by adding at the end the following:

    ``PART P--HIV/AIDS PREVENTION, CARE AND TREATMENT IN DEVELOPING 
                               COUNTRIES

``SEC. 399AA. GENERAL AUTHORITY OF THE CENTERS FOR DISEASE CONTROL AND 
              PREVENTION.

    ``(a) Purpose.--It is the purpose of this section to provide the 
Secretary, acting through the Director of the Centers for Disease 
Control and Prevention, with the authority to act internationally to 
carry out prevention, care, treatment, support, capacity development, 
and other activities (determined appropriate by the Secretary) for HIV/
AIDS, malaria, and tuberculosis in countries determined by the 
Secretary to have or be at risk for severe HIV epidemic with particular 
attention to resource constrained countries.
    ``(b) Activities and Assistance.--In carrying out the purpose 
described in subsection (a), the Secretary, acting through the Director 
of the Centers for Disease Control and Prevention, in coordination with 
the Administrator of the United States Agency for International 
Development and the Administrator of the Health Resources and Services 
Administration, may provide support and assistance under this section 
relating to--
            ``(1) HIV prevention services provided through--
                    ``(A) education and voluntary counseling and 
                testing activities, including rapid testing, the 
                development and application of confidentiality 
                protections with respect to such counseling and 
                testing, and the integration of such activities into 
                programs serving women and children;
                    ``(B) programs to reduce the mother-to-child 
                transmission of HIV, including the treatment and care 
                of HIV-infected women, their children, and families, 
                and including the involvement of fathers in such 
                programs;
                    ``(C) activities involving behavioral interventions 
                for youth, women, and other vulnerable populations;
                    ``(D) programs to prevent the transmission of HIV 
                and other pathogens at health care facilities 
                (including the use of universal precautions, equipment 
                sterilization, post-exposure prophylaxis for health 
                care workers and other individuals determined to be 
                appropriate, and other interventions appropriate to the 
                resources available), and to support the use of post 
                exposure prophylaxis, when indicated, for patients;
                    ``(E) activities to ensure a safe blood supply;
                    ``(F) programs to provide prevention, care, 
                treatment, and patient management services for sexually 
                transmitted infections to infected individuals and 
                individuals at risk of infection; and
                    ``(G) activities, including laboratory support, to 
                collect and maintain accurate HIV/AIDS surveillance and 
                epidemiologic data, to target and monitor programs, and 
                to measure the effectiveness of interventions;
            ``(2) HIV/AIDS care and treatment services provided 
        through--
                    ``(A) programs to provide care and treatment, 
                integrated with prevention services to further reduce 
                the transmission of HIV, for individuals living with 
                HIV/AIDS, including the treatment of opportunistic 
                infections (including tuberculosis) and the provision 
                of antiretroviral therapies and nutritional services;
                    ``(B) programs to provide support services that are 
                needed to enhance the effectiveness of health services 
                and to promote family stability, including services for 
                family members affected by, but not infected with, HIV 
                such as children orphaned by AIDS; and
                    ``(C) programs that link care and treatment 
                services to proven prevention programs, including 
                linkages with voluntary counseling and testing efforts 
                (including rapid testing);
            ``(3) infrastructure and training through--
                    ``(A) activities to improve the health 
                infrastructure and institutional capacity within 
                participating countries, including the training of 
                appropriate personnel, and to assist such countries in 
                expanding and improving the availability of health care 
                facilities, to enable such countries to develop and 
                manage HIV/AIDS education, prevention, care and 
                treatment programs and to conduct evaluations of such 
                programs; and
                    ``(B) activities to provide laboratory support as 
                well as technical assistance and training to increase 
                the capacity for the diagnosis, care, and treatment of 
                HIV/AIDS and related health conditions (including rapid 
                testing);
            ``(4) HIV/AIDS treatment protocols through--
                    ``(A) the provision of support and assistance to 
                countries determined by the Secretary to have or be at 
                risk for severe HIV epidemic with particular attention 
                to resource constrained countries for the development 
                of treatment protocols for the delivery of HIV/AIDS 
treatment and prevention services; and
                    ``(B) the provision of assistance to countries 
                determined by the Secretary to have or be at risk for 
                severe HIV epidemic with particular attention to 
                resource constrained countries and to be ready to 
                implement the protocols described in subparagraph (A); 
                and
            ``(5) other activities determined appropriated by the 
        Secretary.
    ``(c) Utilization of Existing Capacities.--In carrying out 
activities under subsection (b), the Secretary, acting through the 
Director of the Centers for Disease Control and Prevention and in 
coordination with the Administrator of the United States Agency for 
International Development and the Administrator of the Health Resources 
and Services Administration, shall, to the maximum extent practicable, 
utilize existing indigenous capacity in developing countries, including 
coordinating with relevant government ministries and carrying out 
activities in partnership with non-governmental organizations and 
affected communities.
    ``(d) Health Resources and Services Administration.--In carrying 
out activities under paragraphs (2) and (3) of subsection (b), the 
Secretary, acting through the Director of the Centers for Disease 
Control and Prevention, shall enter into interagency agreements, 
monetary transfers, and contracts with the Administrator of the Health 
Resources and Services Administration to ensure that such activities 
benefit from the specialized expertise of such Administration related 
to the assessment of needs as well as the development and 
implementation of community-based systems of care and appropriate 
infrastructure, including the training of health care providers and 
community workers.
    ``(e) Blood Supply.--In carrying out activities under subsection 
(b)(1)(E), the Secretary, acting through the Director of the Centers 
for Disease Control and Prevention, shall assist participating 
countries in developing national, regional, or local systems to--
            ``(1) monitor, manage, and test the blood supply to ensure 
        that such supply is screened for HIV;
            ``(2) increase recruitment and retention of appropriate 
        blood donors; and
            ``(3) provide for technology transfer and capacity building 
        in proven best blood safety practices appropriate to local 
        conditions, including anemia prevention efforts.
    ``(f) Authorization of Appropriations.--There is authorized to be 
appropriated to carry out this section, $400,000,000 for fiscal year 
2003, and such sums as may be necessary for fiscal year 2004. Of the 
amount appropriated under the preceding sentence for each fiscal year, 
the Secretary shall make available $45,000,000 in fiscal year 2003 and 
$30,000,000 in fiscal year 2004 to carry out section 399DD. Amounts 
appropriated under this subsection shall remain available until 
expended.

``SEC. 399BB. GENERAL AUTHORITY OF THE HEALTH RESOURCES AND SERVICES 
              ADMINISTRATION.

    ``(a) Purpose.--It is the purpose of this section to provide the 
Secretary, acting through the Administrator of the Health Resources and 
Services Administration, with the authority to act internationally to 
carry out prevention, care, treatment, support, capacity development, 
and other activities (determined appropriate by the Secretary) for HIV/
AIDS, malaria, and tuberculosis in countries determined by the 
Secretary to have or be at risk for severe HIV epidemic with particular 
attention to resource constrained countries.
    ``(b) Activities and Assistance.--In carrying out the purpose 
described in subsection (a), the Secretary, acting through the 
Administrator of the Health Resources and Services Administration, in 
coordination with the Director of the Centers for Disease Control and 
Prevention and the Administrator of the United States Agency for 
International Development, may provide assistance under this section 
relating to--
            ``(1) activities to assist communities in assessing the 
        strengths and capabilities of the existing system of care and 
        treatment relating to HIV/AIDS and other opportunistic 
        infections, including critical unmet needs;
            ``(2) activities to assist communities in the development 
        and implementation of appropriate systems of care that provide 
        for a continuum of HIV/AIDS-related services for prevention, 
        treatment, palliative care, and hospice services based on an 
        assessment under paragraph (1);
            ``(3) activities to improve the health-related 
        infrastructure and institutional capacity of participating 
        countries, including the training of health care providers and 
        community workers, to enable such countries to develop and 
        manage HIV/AIDS education, prevention, care and treatment 
        programs and to conduct evaluations of such programs;
            ``(4) activities to assist in the development of training 
        modules and curricula on HIV/AIDS and associated conditions as 
        part of the professional training programs for physicians, 
        nurses, dentists, pharmacists, and other health care providers;
            ``(5) activities to improve the coordination between 
        American medical centers and hospitals and indigenous hospitals 
        and clinics in participating countries; and
            ``(6) other activities determined appropriated by the 
        Secretary.
    ``(c) Utilization of Existing Capacities.--In carrying out 
activities under subsection (b), the Secretary, acting through the 
Administrator of the Health Resources and Services Administration and 
in consultation with the Director of the Centers for Disease Control 
and Prevention and the Administrator of the United States Agency for 
International Development, shall, to the maximum extent practicable, 
utilize existing indigenous capacity in countries determined by the 
Secretary to have or be at risk for severe HIV epidemic with particular 
attention to resource constrained countries, including coordinating 
with relevant government ministries and carrying out activities in 
partnership with non-governmental organizations and affected 
communities.
    ``(d) Authorization of Appropriations.--There is authorized to be 
appropriated to carry out this section, $40,000,000 for fiscal year 
2003, and such sums as may be necessary for fiscal year 2004. Amounts 
appropriated under this subsection shall remain available until 
expended.

``SEC. 399CC. HIV/AIDS TRAINING PARTNERSHIP.

    ``(a) In General.--The Secretary, acting through the Director of 
the National Institutes of Health and in coordination with the 
Administrator of the Health Resources and Services Administration, 
shall award supplemental grants to eligible entities to enable such 
entities to provide support for clinical education and training in the 
delivery of HIV/AIDS care and treatment services.
    ``(b) Eligible Entities.--To be eligible to receive a supplemental 
grant under subsection (a), an entity shall--
            ``(1) be a recipient of an international HIV/AIDS clinical 
        research, education, or training grant awarded by the National 
        Institutes of Health or the Health Resources and Services 
        Administration;
            ``(2) provide assurances to the Secretary that the entity 
        has developed a partnership with a hospital-based or community-
        based health care entity in the host country for the purpose of 
        providing services under each grant; and
            ``(3) prepare and submit to the Secretary an application at 
        such time, in such manner, and containing such information as 
        the Secretary may require, including a description of the 
        activities to be carried out with amounts received under the 
        grant.
    ``(c) Use of Funds.--An entity shall use amounts received under a 
supplemental grant under subsection (a) to provide clinical education 
and training in the delivery of HIV/AIDS care and treatment services. 
Such education and training shall be designed to develop health care 
provider capacity to deliver HIV/AIDS care and treatment services in a 
variety of institutional and community-based settings.
    ``(d) Priority.--In awarding grants under subsection (a), the 
Secretary shall give priority to applicants that will carry out 
activities that assess existing provider capacity and address the 
training needs of a range of health care providers (from physicians to 
nurses to other health care providers).
    ``(e) Authorization of Appropriations.--There is authorized to be 
appropriated to carry out this section, $50,000,000 for fiscal year 
2003, and such sums as may be necessary for fiscal year 2004. Amounts 
appropriated under this subsection shall remain available until 
expended.

``SEC. 399DD. FAMILY SURVIVAL PARTNERSHIPS.

    ``(a) Purpose.--The purpose of this section is to provide support, 
through a public-private partnership, for the provision of medical care 
and support services to HIV positive parents and their children 
identified through existing programs to prevent mother-to-child 
transmission of HIV in countries with or at risk for severe HIV 
epidemic with particular attention to resource constrained countries, 
as determined by the Secretary.
    ``(b) Grants.--
            ``(1) In general.--The Secretary, acting through the 
        Director of the Centers for Disease Control and Prevention, is 
        authorized to award a grant to an eligible administrative 
        organization to enable the organization to award subgrants to 
        eligible entities to expand activities to prevent the mother-
        to-child transmission of HIV by providing medical care and 
        support services to HIV infected parents and their children.
            ``(2) Administrative organization.--To be eligible to 
        receive a grant under paragraph (1), an administrative 
        organization shall--
                    ``(A) have a demonstrable record in managing large 
                scale maternal and child health programs in countries 
                with or at risk for severe HIV epidemic with particular 
                attention to resource constrained countries, as 
                determined by the Secretary, and sufficient HIV/AIDS 
                expertise;
                    ``(B) have established relationships with major 
                international organizations and multilateral 
                institutions;
                    ``(C) provide an assurance to the Secretary that 
                the organization will contribute (either directly or 
                through private sector financial support) non-Federal 
                funds to the costs of the activities to be carried out 
                under this section in an amount that is not less than 
                the amount of funds provided to the organization under 
                a grant this section; and
                    ``(D) prepare and submit an application to the 
                Secretary at such time, in such manner, and accompanied 
                by such information as the Secretary may require.
            ``(3) Use of funds.--Amounts provided under a grant awarded 
        under paragraph (1) shall be used--
                    ``(A) to award subgrants to eligible entities to 
                enable such entities to carry out activities described 
                in subsection (c);
                    ``(B) for administrative support and subgrant 
                management;
                    ``(C) for administrative data collection and 
                reporting concerning grant activities;
                    ``(D) for the monitoring and evaluation of grant 
                activities;
                    ``(E) for training and technical assistance for 
                subgrantees; and
                    ``(F) to promote sustainability.
    ``(c) Subgrants.--
            ``(1) In general.--An organization awarded a grant under 
        subsection (b) shall use amounts received under the grant to 
        award subgrants to eligible entities.
            ``(2) Eligibility.--To be eligible to receive a subgrant 
        under paragraph (1), an entity shall--
                    ``(A) be a local health organization, an 
                international organization, or a partnership of such 
                organizations;
                    ``(B) demonstrate to the awarding organization that 
                such entity--
                            ``(i) is currently administering a proven 
                        intervention to prevent mother-to-child 
                        transmission of HIV in countries with or at 
                        risk for severe HIV epidemic with particular 
                        attention to resource constrained countries, as 
                        determined by the Secretary;
                            ``(ii) serves a catchment area with a 
                        minimum HIV seroprevalence of 3 percent in 
                        pregnant women;
                            ``(iii) has demonstrated support for the 
                        proposed program from relevant government 
                        entities;
                            ``(iv) is able to provide HIV care, 
                        including antiretroviral treatment 
when medically indicated, to HIV positive women, men, and children with 
the support of the project funding; and
                            ``(v) has the ability to enroll a minimum 
                        of 250 HIV infected women per service site, 
                        based on the current uptake rate, into existing 
                        HIV mother-to-child transmission programs; and
                    ``(C) prepare and submit to the awarding 
                organization an application at such time, in such 
                manner, and containing such information as the 
                organization may require.
            ``(3) Local health and international organizations.--For 
        purposes of paragraph (2)(A)--
                    ``(A) the term `local health organization' means a 
                public sector health system, non-governmental 
                organization, institution of higher education, 
                community-based organization, or non-profit health 
                system that provides directly, or has a clear link with 
                a provider for the indirect provision of, primary 
                health care services; and
                    ``(B) the term `international organization' means--
                            ``(i) a non-profit international entity;
                            ``(ii) an international charitable 
                        institution;
                            ``(iii) a private voluntary international 
                        entity; or
                            ``(iv) a multilateral institution.
            ``(4) Selection of subgrant recipients.--In awarding 
        subgrants under this subsection, the organization shall--
                    ``(A) consider applicants from a range of health 
                care settings, program approaches, and geographic 
                locations; and
                    ``(B) if appropriate, award not less than 1 grant 
                to an applicant to fund a national system of health 
                care delivery to HIV positive families.
            ``(5) Use of subgrant funds.--An eligible entity awarded a 
        subgrant under this subsection shall use subgrant funds to 
        expand activities to prevent mother-to-child transmission of 
        HIV by providing medical treatment and care and support 
        services to parents and their children, including--
                    ``(A) providing treatment and therapy, when 
                medically indicated, to HIV-infected women, their 
                children, and families;
                    ``(B) the hiring and training of local personnel, 
                including physicians, nurses, other health care 
                providers, counselors, social workers, outreach 
                personnel, laboratory technicians, data managers, and 
                administrative support personnel;
                    ``(C) paying laboratory costs, including costs 
                related to necessary equipment and diagnostic testing 
                and monitoring (including rapid testing), complete 
                blood counts, standard chemistries, and liver function 
                testing for infants, children, and parents, and costs 
                related to the purchase of necessary laboratory 
                equipment;
                    ``(D) purchasing pharmaceuticals for HIV-related 
                conditions, including antiretroviral therapies;
                    ``(E) funding support services including adherence 
                and psychosocial support services;
                    ``(F) operational support activities; and
                    ``(G) conducting community outreach and capacity 
                building activities, including activities to raise the 
                awareness of individuals of the program carried out by 
                the subgrantee, other communications activities in 
                support of the program, local advisory board functions, 
                and transportation necessary to ensure program 
                participation.
    ``(d) Reports.--Not later than 6 months after the date of enactment 
of this section, and annually thereafter, an administrative 
organization awarded a grant under subsection (b)(1) shall submit to 
the Secretary and the appropriate committees of Congress, a report that 
includes--
            ``(1) the progress of programs funded under this section;
            ``(2) the benchmarks of success of programs funded under 
        this section; and
            ``(3) recommendations of how best to proceed with the 
        programs funded under this section upon the expiration of 
        funding under subsection (e).
    ``(e) Funding.--In making amounts available under section 399AA(f) 
to carry out this section, the Secretary shall ensure that not less 
than--
            ``(1) $45,000,000 is made available to carry out this 
        section for fiscal year 2003; and
            ``(2) $30,000,000 is made available to carry out this 
        section for fiscal year 2004.
    ``(f) Limitation on Administrative Expenses.--An administrative 
organization shall ensure that not more than 12 percent of the amount 
of a grant received under this section by the organization is used for 
the administrative activities described in subparagraphs (B), (C), (D), 
and (E) of subsection (b)(3) and subsection (b)(5)(E).

``SEC. 399EE. INTRA-AGENCY COORDINATION OF GLOBAL HIV/AIDS INITIATIVES.

    ``(a) In General.--The Secretary, acting through the Director of 
the Office of Global Health Affairs (referred to in this section as the 
`Director') of the Department of Health and Human Services (referred to 
in this section as the `Department'), shall ensure--
            ``(1) the coordination of all Department programs related 
        to the prevention, treatment, and monitoring of HIV/AIDS, 
        malaria, and tuberculosis in countries with or at risk for 
        severe HIV epidemic with particular attention to resource 
        constrained countries, as determined by the Secretary (referred 
        to in this section as `Department programs'); and
            ``(2) that global HIV/AIDS, malaria, and tuberculosis 
        activities are conducted in a coordinated, strategic fashion, 
        utilizing the expertise from the various agencies within the 
        Department, to the maximum extent practicable.
    ``(b) Duties.--In carrying out this section, the Secretary shall--
            ``(1) review all Departmental programs to ensure proper 
        coordination and compatibility of the activities, strategies, 
        and policies of such programs; and
            ``(2) ensure that the Departmental programs utilize the 
        best possible practices for HIV/AIDS prevention, treatment, and 
        monitoring to improve the effectiveness of Department programs 
        in countries in which the Department operates.
    ``(c) Report.--
            ``(1) In general.--The Director shall prepare an annual 
        report that--
                    ``(A) describes the actions that are being taken to 
                coordinate the multiple roles and policies of, and 
                foster collaboration among, the offices and agencies of 
                the Department that contribute to global HIV/AIDS 
                activities;
                    ``(B) describes the respective roles and activities 
                of each of the offices and agencies of the Department;
                    ``(C) contains any recommendations for legislative 
                and funding actions that are needed to create a 
                coherent, effective departmental approach to global 
                HIV/AIDS that achieves the goals for Department 
                programs; and
                    ``(D) describes the progress made towards meeting 
                the HIV/AIDS goals and outcomes as identified by the 
                Director.
            ``(2) Submission to congress.--Not later than 1 year after 
        the date of enactment of this part, and annually thereafter, 
        the Secretary shall submit the report described in paragraph 
        (1) to the appropriate committees of Congress.''.
    (b) Extension of Tuberculosis Prevention Program.--Section 317E(g) 
of the Public Health Service Act (42 U.S.C. 247b-6(g)) is amended--
            (1) in paragraph (1)(A), by striking ``2002'' and inserting 
        ``2004'';
            (2) in paragraph (2), by striking ``2002'' and inserting 
        ``2004''; and
            (3) by adding at the end the following:
            ``(3) Coordination.--Activities under this section shall, 
        to the extent practicable, be coordinated with related 
        activities carried out under the International AIDS Treatment 
        and Prevention Act of 2002 (and the amendments made by that 
        Act).''.

SEC. 3. MICROBICIDE RESEARCH AT THE NATIONAL INSTITUTES OF HEALTH.

    Subpart I of part D of title XXIII of the Public Health Service Act 
(42 U.S.C. 300cc-40 et seq.) is amended by inserting after section 2351 
the following:

``SEC. 2351A. MICROBICIDES FOR PREVENTING TRANSMISSION OF HIV AND OTHER 
              SEXUALLY TRANSMITTED INFECTIONS.

    ``(a) Expansion and Coordination of Activities.--The Secretary, 
acting through the Director of the Office of AIDS Research and in 
coordination with other relevant institutes and offices, shall expand, 
intensify, and coordinate the activities of all appropriate institutes 
and components of the National Institutes of Health with respect to 
research on the development of microbicides to prevent the transmission 
of HIV and other sexually transmitted infections (in this section 
referred to as `microbicide research').
    ``(b) Research Plan.--The Secretary, acting through the Director of 
the Office of AIDS Research and in consultation with the Director of 
the Institute of Allergy and Infectious Diseases, shall expedite the 
implementation of the strategic plan for the conduct and support of 
microbicide research, and shall annually review and as appropriate 
revise the plan. In developing, implementing, and reviewing the plan, 
the Director of the Office of AIDS Research shall coordinate with the 
heads of other Federal agencies, including the Director of the Centers 
for Disease Control and Prevention and the Administrator of the United 
States Agency for International Development, involved in microbicide 
research, with the microbicide research community, and with health 
advocates.
    ``(c) Microbicide Research and Development Teams.--
            ``(1) In general.--The Secretary, acting through the 
        Director of the National Institutes of Health, shall award 
        grants or contracts to public and private entities for the 
        development and operation of multidisciplinary teams to conduct 
        research on innovative microbicide concepts, including 
        combination microbicides.
            ``(2) Peer review requirement.--The Director shall award a 
        grant or contract to an entity under paragraph (1) only if the 
        grant or contract has been recommended after technical and 
        scientific peer review in accordance with regulations under 
        section 492.
    ``(d) Report.--Not later than 1 year after the date of the initial 
submission of the research plan under subsection (b), and annually 
thereafter, the Secretary, acting through the Director of the Office of 
AIDS Research and in consultation with the Director of the Institute of 
Allergy and Infectious Diseases, shall submit to the Committee on 
Energy and Commerce and the Committee on Appropriations of the House of 
Representatives and the Committee on Health, Education, Labor, and 
Pensions and the Committee on Appropriations of the Senate a report 
that describes the activities of the National Institutes of Health 
regarding microbicide research. Each such report shall include--
            ``(1) an updated research plan;
            ``(2) a description and evaluation of the progress made, 
        during the period for which such report is prepared, in 
        research on microbicides;
            ``(3) a summary and analysis of expenditures made, during 
        the period for which the report is made, for activities with 
        respect to microbicides research conducted and supported by the 
        National Institutes of Health, including the number of full-
        time equivalent employees; and
            ``(4) recommendations as the Director of the Office of AIDS 
        Research considers appropriate.
    ``(f) Definition.--In this section, the term `HIV' means the human 
immunodeficiency virus. Such term includes acquired immune deficiency 
syndrome.''.

SEC. 4. AUTHORITY OF THE DEPARTMENT OF LABOR.

    (a) Purpose.--It is the purpose of this section to provide the 
Secretary of Labor with the authority to carry out workplace-based HIV/
AIDS programs in countries with or at risk for severe HIV epidemic with 
particular attention to resource constrained countries, as determined 
by the Secretary.
    (b) Activities and Assistance.--In carrying out the purpose 
described in subsection (a), the Secretary of Labor, in coordination 
with the Secretary of Health and Human Services and the Administrator 
of the United States Agency for International Development, may provide 
assistance under this section relating to--
            (1) the establishment and implementation of workplace HIV/
        AIDS prevention and education programs in countries with or at 
        risk for severe HIV epidemic with particular attention to 
        resource constrained countries, as determined by the Secretary, 
        including programs that emphasize protections against 
        discrimination and the creation of supportive environments for 
        individuals living with HIV/AIDS;
            (2) the development and implementation of on-site care and 
        wellness programs that enhance the health and productivity of 
        the workforce in countries with or at risk for severe HIV 
        epidemic with particular attention to resource constrained 
        countries, as determined by the Secretary;
            (3) activities to strengthen collaboration among 
        governments, business, and labor leaders to respond to the HIV/
        AIDS pandemic; and
            (4) other activities determined appropriated by the 
        Secretary.
    (c) Authorization of Appropriations.--There is authorized to be 
appropriated to carry out this section, $10,000,000 for fiscal year 
2003, and such sums as may be necessary for fiscal year 2004 Amounts 
appropriated under this subsection shall remain available until 
expended.

SEC. 5. AUTHORITY FOR INTERNATIONAL PROGRAMS.

    Section 307 of the Public Health Service Act (42 U.S.C. 242l) is 
amended--
            (1) in subsection (b)--
                    (A) in paragraph (6), by adding ``and'' at the end;
                    (B) in paragraph (7), by striking ``; and'' and 
                inserting a period;
                    (C) in the flush sentence after paragraph (7), by 
                inserting ``new'' before ``facility in any foreign 
                country''; and
                    (D) by striking paragraph (8); and
            (2) by adding at the end the following:
    ``(d)(1) The Secretary is authorized to utilize the authority 
contained in section 2 of the State Department Basic Authorities Act of 
1956 (22 U.S.C. 2669), subject to the limitations set forth in 
subsection (e).
    ``(2) The Secretary is authorized to use the authority contained in 
section 1 of the Act of April 18, 1930 (46 Stat. 177; 22 U.S.C. 291) 
and section 1 of the Foreign Service Buildings Act (22 U.S.C. 292) 
directly or through contract, grant, or cooperative agreement to lease, 
alter, or renovate facilities in foreign countries as necessary to 
conduct programs of assistance for international health activities, 
including activities relating to HIV/AIDS and other infectious 
diseases, chronic and environmental diseases, and other health 
activities abroad.
    ``(e) In exercising the authority set forth in paragraphs (1) and 
(2) of subsection (d), the Secretary shall consult with the Secretary 
of State to ensure that planned activities are within the legal 
strictures of the State Department Basic Authorities Act of 1956 and 
other applicable laws.''.




                                                       Calendar No. 484

107th CONGRESS

  2d Session

                                S. 2649

_______________________________________________________________________

                                 A BILL

  To provide assistance to combat the HIV/AIDS pandemic in developing 
                           foreign countries.

_______________________________________________________________________

                              July 3, 2002

  Reported under the authority of the order of the Senate of June 26, 
                        2002, with an amendment