[Congressional Bills 108th Congress]
[From the U.S. Government Publishing Office]
[S. 1009 Placed on Calendar Senate (PCS)]






                                                        Calendar No. 88
108th CONGRESS
  1st Session
                                S. 1009

 To amend the Foreign Assistance Act of 1961 and the State Department 
   Basic Authorities Act of 1956 to increase assistance for foreign 
 countries seriously affected by HIV/AIDS, tuberculosis, and malaria, 
                        and for other purposes.


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

                              May 7, 2003

  Mr. Lugar (for himself, Mr. Biden, Mr. Kerry, Mr. Daschle, and Mr. 
 Sarbanes) introduced the following bill; which was read the first time

                              May 8, 2003

            Read the second time and placed on the calendar

_______________________________________________________________________

                                 A BILL


 
 To amend the Foreign Assistance Act of 1961 and the State Department 
   Basic Authorities Act of 1956 to increase assistance for foreign 
 countries seriously affected by HIV/AIDS, tuberculosis, and malaria, 
                        and for other purposes.

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

SECTION 1. SHORT TITLE; TABLE OF CONTENTS.

    (a) Short Title.--This Act may be cited as the ``United States 
Emergency Plan for AIDS Relief Act of 2003''.
    (b) Table of Contents.--The table of contents for this Act is as 
follows:

Sec. 1. Short title; table of contents.
Sec. 2. Findings.
Sec. 3. Definitions.
Sec. 4. Purpose.
               TITLE I--POLICY PLANNING AND COORDINATION

Sec. 101. Development of a comprehensive, five-year, global strategy.
Sec. 102. HIV/AIDS response coordinator.
Sec. 103. Coordination with foreign policy.
Sec. 104. Reporting requirements.
Sec. 105. Authorization of appropriations.
Sec. 106. Authority to consolidate and combine reports.
                 TITLE II--PUBLIC-PRIVATE PARTNERSHIPS

Sec. 201. Sense of Congress regarding public-private partnerships.
Sec. 202. Participation in the Global Fund to Fight AIDS, Tuberculosis 
                            and Malaria.
Sec. 203. Voluntary contributions to international vaccine funds.
                    TITLE III--MULTILATERAL EFFORTS

Sec. 301. Authority for debt relief for qualified HIPC countries.
Sec. 302. Sense of Congress regarding the enhanced HIPC initiative.
Sec. 303. Definitions.
Sec. 304. Authorization of appropriations.
                      TITLE IV--BILATERAL EFFORTS

Sec. 401. Assistance to combat HIV/AIDS.
Sec. 402. Assistance to combat tuberculosis.
Sec. 403. Assistance to combat malaria.
Sec. 404. Department of Defense HIV/AIDS prevention assistance program.
                      TITLE V--BUSINESS PRINCIPLES

Sec. 501. Findings.
Sec. 502. Sense of Congress regarding principles for United States 
                            firms operating in countries affected by 
                            the HIV/AIDS pandemic.
Sec. 503. Principles and practices.

SEC. 2. FINDINGS.

    Congress makes the following findings:
            (1) During the last 20 years, the HIV/AIDS pandemic has 
        spread from the most severely affected regions, sub-Saharan 
        Africa and the Caribbean, to all corners of the world, leaving 
        an unprecedented path of death and devastation. Sub-Saharan 
        Africa remains the hardest hit region in the world.
            (2) According to UNAIDS, more than 60,000,000 people 
        worldwide have been infected with HIV since the epidemic began, 
        more than 22,000,000 of these have lost their lives to AIDS, 
        and more than 13,000,000 children have been orphaned by that 
        disease.
            (3) HIV/AIDS is the fourth-highest cause of death in the 
        world.
            (4) At the end of 2002, an estimated 42,000,000 people were 
        infected with HIV or were living with AIDS. More than 75 
        percent of those people live in Africa or the Caribbean region, 
        and more than 3,000,000 were children under the age of 15 and 
        more than 17,600,000 were women.
            (5) Fifty percent of the total number of individuals 
        infected with HIV or living with AIDS worldwide and 70 percent 
        of such individuals living in Africa reside in one of the 
        following fourteen countries: Botswana, Cote d'Ivoire, 
        Ethiopia, Guyana, Haiti, Kenya, Mozambique, Namibia, Nigeria, 
        Rwanda, South Africa, Tanzania, Uganda, and Zambia.
            (6) An estimated 2,000,000 people in Latin America and the 
        Caribbean region and another 7,200,000 people in Asia and the 
        Pacific region are infected with HIV or living with AIDS.
            (7) Infection rates are rising alarmingly in Eastern Europe 
        (especially in the Russian Federation), Central Asia, China, 
        and India.
            (8) Rape, sexual assault, sexual abuse, and prostitution 
        place women and children at heightened risk for HIV infection 
        and other health risks in many countries. Women and children 
        who are refugees or are internally displaced persons are 
        especially vulnerable to sexual violence. Spouses or partners 
        of men who solicit prostitutes are also put at risk as a result 
        of the sex trade.
            (9) Effective measures are needed to empower women, 
        including discouraging the sex industry and the trafficking of 
        individuals in that industry which contributes to the spread of 
        and devastation caused by HIV/AIDS.
            (10) HIV/AIDS has a devastating impact on the social 
        cohesion and economic well-being of the family. When a family 
        member infected with HIV develops AIDS, limited family 
        resources are expended on care and treatment. The economic 
        impact is more severe if the infected family member is the 
        primary source of income for the family. Other family members 
        are forced to work to support the family and children often 
        drop out of school to serve as caregivers. Care, treatment, and 
        support of families affected by AIDS are critical elements of 
        an effective strategy to reduce the spread and impact of HIV/
        AIDS.
            (11) HIV/AIDS undermines the economic security of a country 
        and the vitality of individual businesses by weakening the 
        productivity and longevity of the labor force across a broad 
        array of economic sectors and by reducing the potential for 
        economic growth over the long term.
            (12) HIV/AIDS destabilizes communities by striking at the 
        most mobile and educated members of society.
            (13) HIV/AIDS weakens national defenses of countries that 
        are severely affected by the pandemic through high infection 
        rates among members of their military forces. According to 
        UNAIDS, in sub-Saharan Africa, many military forces have 
        infection rates as much as five times the rates of the civilian 
        population.
            (14) The devastation wrought by the HIV/AIDS pandemic is 
        compounded by the prevalence of tuberculosis and malaria, 
        particularly in developing countries where the poorest and most 
vulnerable members of society, including women, children, and those 
with HIV/AIDS, become infected with tuberculosis or malaria. According 
to the World Health Organization HIV, AIDS, tuberculosis, and malaria 
accounted for approximately 6,000,000 deaths in 2002 and caused 
debilitating illnesses in millions more.
            (15) Tuberculosis is the cause of death for one out of 
        every three persons who have AIDS worldwide and is a highly 
        communicable disease. HIV infection is the leading threat to 
        control of tuberculosis. Because HIV infection so severely 
        weakens the immune system, individuals with HIV and latent 
        tuberculosis infection have a 100 times higher risk of 
        developing active tuberculosis diseases, thereby increasing the 
        risk of spreading tuberculosis to others. Tuberculosis, in 
        turn, accelerates the onset of AIDS in individuals infected 
        with HIV.
            (16) Malaria, the most deadly of all tropical parasitic 
        diseases, has been undergoing a dramatic resurgence in recent 
        years due to increasing resistance of the malaria parasite to 
        inexpensive, effective drugs and, concurrently, increasing 
        resistance of mosquitoes to standard insecticides. The World 
        Health Organization estimates that between 300,000,000 and 
        500,000,000 new cases of malaria occur each year, and annual 
        deaths from the disease number between 2,000,000 and 3,000,000. 
        Persons infected with HIV are particularly vulnerable to the 
        malaria parasite. The spread of HIV infection contributes to 
        the difficulties of controlling resurgence of the drug 
        resistant malaria parasite.
            (17) The HIV/AIDS pandemic is first and foremost a public 
        health problem. Successful strategies to stem the spread of the 
        pandemic will require direct medical interventions, as well as 
        the strengthening of health care delivery systems and 
        infrastructure, determined national leadership, and increased 
        budgetary allocations for the health sector in countries 
        affected by the pandemic. Effective prevention measures are 
        also needed to address the social and behavioral factors that 
        contribute to the spread of HIV/AIDS.
            (18) Effective HIV prevention activities require a variety 
        of strategies, including those that eliminate the risk of 
        infection and those that reduce it.
            (19) Uganda has implemented a successful strategy to 
        prevent the spread of HIV that includes a nationwide education 
        campaign, the use of a model that encourages individuals to 
        practice abstinence, be faithful, and use condoms (the ``ABC'' 
        model), and the provision of care and treatment. The ABC model 
        emphasizes behavior change, including sexual abstinence, 
        delaying sexual debut, fidelity to one's partner, limiting the 
        number of sexual partners, and using condoms. As a result, 
        Uganda has experienced the most significant decline in HIV 
        infection rates of any country in Africa. Other nations, 
        including Jamaica, Zambia, Ethiopia, and Senegal, have 
        implemented the ABC model with positive results. Uganda's 
        success demonstrates that the ABC model can be an effective 
        approach to prevent HIV infection in some countries and is, 
        therefore, an important component of a global strategy to 
        prevent the sexual transmission of HIV.
            (20) In 2002, the President initiated a mother-to-child 
        transmission prevention program to combat the global tragedy of 
        HIV/AIDS being transmitted to newborns by their mothers. The 
        President's program recognizes that approximately 2,000 
        children around the world are infected each day with HIV 
        through mother-to-child transmission and that mother-to-child 
        transmission is largely preventable with the proper application 
        of pharmaceuticals, therapies, and other public health 
        interventions. The United States Government is already 
        supporting programs to prevent mother-to-child transmission in 
        resource-poor nations.
            (21) Efforts to prevent mother-to-child transmission have 
        provided the basis for a broader response that includes care 
        and treatment of mothers, fathers, other family members, and 
        the population-at-large, that are infected with HIV or living 
        with AIDS.
            (22) Advances in treatment for HIV/AIDS provide the 
        opportunity, for the first time, for meaningful clinical 
        interventions on a large scale in developing countries. 
        Experience in Uganda and Haiti shows that interventions based 
        upon a progressive, tiered model of health care delivery 
        emanating from a central health care facility that is extended 
        through expanding circles of delivery using local mechanisms 
        and local capacity, thus allowing delivery of care and 
        treatment through basic levels of expertise, are critical to 
        increasing access to treatment in resource-poor countries. Such 
        a model is highly cost-effective and maximizes utilization of 
        local resources.
            (23) The magnitude and scope of the HIV/AIDS crisis demands 
        a comprehensive, long-term, international response that is 
        focused on providing an integrated program of treatment, care, 
        and prevention that recognizes recent medical insights and 
        includes--
                    (A) prevention and education, care and treatment, 
                basic and applied research, and training of health care 
                workers (particularly at the community and provincial 
                levels) and other community workers and leaders needed 
                to cope with the range of challenges in the HIV/AIDS 
                crisis;
                    (B) development of health care infrastructure and 
                delivery systems through cooperative and coordinated 
                public efforts, and public and private partnerships;
                    (C) development and implementation of national and 
                community-based multisector strategies that address the 
                impact of HIV/AIDS on the individual, family, 
                community, and nation and increase the participation of 
                at-risk populations in programs designed to encourage 
                behavioral and social change and reduce the stigma 
associated with infection with HIV and living with AIDS;
                    (D) use of all available expertise and experience 
                within the United States Government to assist in the 
                development of an international response to the HIV/
                AIDS crisis; and
                    (E) coordination of efforts between international 
                organizations such as the Global Fund to Fight AIDS, 
                Tuberculosis and Malaria, UNAIDS, the World Health 
                Organization, national governments, and private sector 
                organizations (including nonprofit, community-based, or 
                faith-based organizations).
            (24) Leadership of the international community's response 
        to the HIV/AIDS pandemic requires the United States--
                    (A) to continue to provide substantial financial 
                resources, technical expertise, and training;
                    (B) to promote vaccine and microbicide research and 
                the development of new treatment protocols in the 
                public and commercial pharmaceutical research sectors;
                    (C) to encourage governments and community-based 
                organizations to adopt policies that treat HIV/AIDS as 
                a public health problem with multisectoral impacts, 
                including impacts on education, the economy, the 
                family, and society;
                    (D) to ensure that--
                            (i) the particular vulnerabilities of women 
                        are addressed when designing appropriate HIV/
                        AIDS prevention and treatment programs, given 
                        the fact that women face a high risk of HIV 
                        infection due, in part, to rape, sexual 
                        assault, prostitution, the sex trade, and the 
                        sexual exploitation of women; and
                            (ii) no microbicide is procured or 
                        distributed until such microbicide is proven 
                        both effective to reduce a woman's risk of 
                        contracting HIV or other sexually transmitted 
                        disease and safe for human use; and
                    (E) to encourage active involvement of the private 
                sector, including businesses, pharmaceutical and 
                biotechnology companies, the medical and scientific 
                communities, charitable foundations, private and 
                voluntary organizations, nongovernmental organizations 
                (including nonprofit, community-based, or faith-based 
                organizations) and other nonprofit entities.
            (25) The Emergency Plan for AIDS Relief, announced by the 
        President in January 2003, presents a bold, new bilateral 
        initiative to help countries in Africa and the Caribbean region 
        address the HIV/AIDS pandemic by providing substantial 
        financial resources, technical expertise and training. The 
        Emergency Plan for AIDS Relief recognizes the critical link 
        between HIV/AIDS care, treatment, prevention, and education 
        efforts, and the need for health care systems with the capacity 
        to provide treatment.

SEC. 3. DEFINITIONS.

    In this Act:
            (1) AIDS, HIV, HIV/AIDS.--
                    (A) AIDS.--The term ``AIDS'' means acquired immune 
                deficiency syndrome.
                    (B) HIV.--The term ``HIV'' means the human 
                immunodeficiency virus, the pathogen that causes AIDS.
                    (C) HIV/AIDS.--The term ``HIV/AIDS'' means the 
                disease characterized by HIV infection, or by HIV 
                infection and onset of AIDS.
            (2) Appropriate congressional committees.--The term 
        ``appropriate congressional committees'' means the Committee on 
        Foreign Relations of the Senate and the Committee on 
        International Relations of the House of Representatives.
            (3) Global fund.--The term ``Global Fund'' means the 
        public-private partnership known as the Global Fund to Fight 
        AIDS, Tuberculosis and Malaria that was established under the 
        laws of Switzerland in January 2002.
            (4) Relevant executive branch agencies.--The term 
        ``relevant executive branch agencies'' means the Department of 
        State, the United States Agency for International Development, 
        the Department of Health and Human Services, the Department of 
        Labor, the Department of Commerce, the Department of the 
        Treasury, and the Department of Defense.
            (5) UNAIDS.--The term ``UNAIDS'' means the Joint United 
        Nations Program on HIV/AIDS.

SEC. 4. PURPOSE.

    The purpose of this Act is to strengthen United States leadership 
and the effectiveness of the United States response to global HIV/AIDS, 
tuberculosis, and malaria by--
            (1) providing resources for United States bilateral efforts 
        to combat HIV/AIDS, in order to provide, during the five-fiscal 
        year period beginning with fiscal year 2004--
                    (A) antiretroviral treatment for HIV infection, 
                symptoms of HIV/AIDS, and opportunistic infections 
                associated with HIV/AIDS to at least 2,000,000 
                individuals;
                    (B) support services to at least 10,000,000 
                individuals affected by HIV/AIDS, including the 
                caregivers of individuals infected with HIV or living 
                with AIDS, and children orphaned by HIV/AIDS and the 
                caregivers of such children; and
                    (C) strategies to prevent at least 7,000,000 
                individuals from becoming infected with HIV, including 
                strategies to prevent the transmission of HIV from 
                mothers to infants;
            (2) improving coordination among relevant executive branch 
        agencies to combat the HIV/AIDS pandemic;
            (3) providing resources for United States bilateral efforts 
        to combat tuberculosis and malaria;
            (4) providing resources for multilateral efforts to fight 
        HIV/AIDS, tuberculosis, and malaria;
            (5) encouraging private sector efforts and public-private 
        partnerships to combat HIV/AIDS, tuberculosis, and malaria; and
            (6) providing resources for the development and, when 
        feasible, distribution of safe and effective microbicides and 
        vaccines for HIV/AIDS, and vaccines for tuberculosis and 
        malaria.

               TITLE I--POLICY PLANNING AND COORDINATION

SEC. 101. DEVELOPMENT OF A COMPREHENSIVE, FIVE-YEAR, GLOBAL STRATEGY.

    (a) In General.--The President shall develop a comprehensive, 
integrated five-year strategy to strengthen the capacity of the United 
States to be an effective leader of the international campaign against 
HIV/AIDS and to promote the stabilization or reduction of the global 
incidence of HIV/AIDS and the morbidity and mortality related to HIV/
AIDS. The strategy should include programs to prevent HIV infection 
(including preventing mother-to-child transmission), and to provide 
care and treatment of individuals infected with HIV, and care of 
children orphaned by AIDS. The strategy should be designed to respond 
to the changing nature of the HIV/AIDS pandemic and to the specific 
needs of countries impacted by the pandemic.
    (b) Content.--The strategy required by subsection (a) shall--
            (1) include specific objectives, multisectoral approaches, 
        and strategies to treat individuals infected with HIV and to 
        prevent the further spread of HIV infections, with a particular 
        focus, where appropriate, on clinical interventions based upon 
        a tiered approach to direct delivery of care and treatment 
        through a system that is based upon central facilities and is 
        augmented by expanding circles of local delivery of care and 
        treatment through local systems and capacity;
            (2) provide for the use of effective and proven models that 
        address the specific characteristics of the spread of the HIV/
        AIDS pandemic in countries that will receive assistance 
        pursuant to the strategy;
            (3) use all available expertise and experience within the 
        United States Government to develop an effective response to 
        the global HIV/AIDS crisis, and assign priorities to activities 
        related to HIV/AIDS that will be carried out by the relevant 
        executive branch agencies;
            (4) improve coordination among relevant executive branch 
        agencies, foreign governments, and international organizations;
            (5) require agencies to project the level of resources that 
        will be needed to implement such strategy;
            (6) expand public-private partnerships and efforts to 
        combine funds from the Federal Government with funds from other 
        sources to carry out programs related to HIV/AIDS;
            (7) maximize United States capabilities in the areas of 
        direct delivery of care and treatment, technical assistance, 
        training, and research;
            (8) emphasize behavioral changes to reduce the risk of HIV 
        infection including utilizing a model that encourages 
        individuals to practice abstinence, be faithful, and use 
        condoms (the ``ABC'' model);
            (9) address the vulnerabilities of women to HIV/AIDS, 
        including through prevention and education programs that 
        protect women against HIV/AIDS; and
            (10) provide for tracking measurable results and outcomes 
        from the activities carried out under the strategy.
    (c) Report.--
            (1) Requirement.--Not later than 180 days after the date of 
        the enactment of this Act, the Coordinator of United States 
        Government Activities to Combat HIV/AIDS Globally appointed by 
        the President under section 1(f) of the State Department Basic 
        Authorities Act of 1956 (22 U.S.C. 2651a), as added by section 
        102, shall submit a report to the appropriate congressional 
        committees setting forth the five-year strategy required by 
        subsection (a).
            (2) Content.--The report shall describe the programs and 
        activities that will be implemented under the strategy to 
        address the requirements set out in paragraphs (1) through (10) 
        of subsection (b).

SEC. 102. HIV/AIDS RESPONSE COORDINATOR.

    (a) Establishment of Position.--Section 1 of the State Department 
Basic Authorities Act of 1956 (22 U.S.C. 2651a) is amended--
            (1) by redesignating subsection (f) as subsection (g); and
            (2) by inserting after subsection (e) the following new 
        subsection (f):
    ``(f) HIV/AIDS Response Coordinator.--
            ``(1) In general.--There shall be established within the 
        Department of State, in the immediate office of the Secretary 
        of State, the position of Coordinator of United States 
        Government Activities to Combat HIV/AIDS Globally (the 
        `Coordinator'). The Coordinator shall be appointed by the 
        President, by and with the advice and consent of the Senate, 
        shall report directly to the Secretary of State, and shall have 
        the rank and status of ambassador.
            ``(2) Authorities.--The Coordinator is authorized--
                    ``(A) to coordinate the prevention, care, 
                treatment, support, capacity development, and other 
                activities for combatting the global HIV/AIDS pandemic;
                    ``(B) to designate specific countries to receive 
                assistance related to HIV/AIDS authorized under this 
                Act;
                    ``(C) to transfer and allocate funds in the account 
                established by section 102(c) of the United States 
                Emergency Plan for AIDS Relief Act of 2003 to relevant 
                executive branch agencies; and
                    ``(D) to award grants and contracts, in accordance 
                with Federal law and policy governing the awarding of 
                grants and contracts, to nongovernmental organizations 
                (including nonprofit, community-based, or faith-based 
                organizations) to carry out the duties of the 
                Coordinator.
            ``(3) Duties.--
                    ``(A) In general.--The Coordinator shall have 
                primary responsibility for the oversight and 
                coordination of all activities of the United States 
                Government to combat the international HIV/AIDS 
                pandemic, including all programs, projects, and 
                activities of the United States Government related to 
                HIV/AIDS under the United States Emergency Plan for 
                HIV/AIDS Relief Act of 2003 or any amendment made by 
                such Act.
                    ``(B) Specific duties.--The duties of the 
                Coordinator shall include the following:
                            ``(i) Interagency coordination.--Ensuring 
                        program and policy coordination among the 
                        relevant executive branch agencies, including 
                        audit and evaluation of all such programs.
                            ``(ii) Nongovernmental organizations.--
                        Ensuring that any nongovernmental organization 
                        (including a faith-based organization) seeking 
                        to participate in a program subject to the 
                        authority of the Coordinator--
                                    (I) is not required to support or 
                                perform elements of the program that 
                                are contrary to the principles of such 
                                organization and that such organization 
                                will not be precluded, by not 
                                participating in one aspect of a 
                                program, from participating in any 
                                other aspect of such program as long as 
                                the failure of such organization to 
                                participate in one aspect of the 
                                program does not prejudice the 
                                comprehensiveness and effectiveness of 
                                the program or of the overall United 
                                States effort to combat global HIV/
                                AIDS; and
                                    (II) provides services on a non-
                                discriminatory basis to persons who are 
                                eligible to participate in the program.
                            ``(iii) Agency expertise.--Ensuring that 
                        each relevant executive branch agency 
                        undertakes programs primarily in those areas 
                        where the agency has the most expertise, 
                        technical capabilities, and potential for 
                        success relative to other executive branch 
                        agencies.
                            ``(iv) Efficiency.--Avoiding duplication of 
                        effort.
                            ``(v) International coordination.--Pursuing 
                        coordination with other countries and 
                        international organizations.
                            ``(vi) Disputes resolution.--Resolving 
                        policy, program, and funding disputes among the 
                        relevant executive branch agencies.
                            ``(vii) Financial oversight.--Establishing 
                        appropriate financial accounting criteria for 
                        oversight of funds in the account established 
                        by section 102(c) of the United States 
                        Emergency Plan for AIDS Relief Act of 2003.
                            ``(viii) Monitoring and evaluation of 
                        outcomes.--Establishing appropriate monitoring 
                        and evaluation criteria to assess the 
                        measurable outcomes of all activities subject 
                        to the authority of the Coordinator.
            ``(4) Definitions.--In this subsection:
                    ``(A) AIDS.--The term `AIDS' means acquired immune 
                deficiency syndrome.
                    ``(B) HIV.--The term `HIV' means the human 
                immunodeficiency virus, the pathogen that causes AIDS.
                    ``(C) HIV/AIDS.--The term `HIV/AIDS' means the 
                disease characterized by HIV infection, or by HIV 
                infection and onset of AIDS.
                    ``(D) Relevant executive branch agencies.--The term 
                `relevant executive branch agencies' means the 
                Department of State, the United States Agency for 
                International Development, the Department of Health and 
                Human Services, the Department of Labor, the Department 
                of Commerce, the Department of the Treasury, and the 
                Department of Defense.''.
    (b) Resources.--Not later than 90 days after the date of the 
enactment of this Act, the Secretary of State shall designate the 
necessary financial resources from funds authorized to be appropriated 
under this Act, together with the personnel resources, that should be 
assigned to and under the direct control of the Coordinator of United 
States Government Activities to Combat HIV/AIDS Globally.
    (c) Establishment of Separate Account.--There is established on the 
books of the Treasury an account to be known as the Activities to 
Combat HIV/AIDS Globally Fund, which shall be administered by the 
Coordinator of United States Government Activities to Combat HIV/AIDS 
Globally. There shall be deposited into the account all amounts made 
available pursuant to section 105. Amounts in the Fund shall be 
available for the purposes of this Act, and may be transferred to other 
relevant executive branch agencies under the authority of section 632 
of the Foreign Assistance Act of 1961 (22 U.S.C. 2392).
    (d) Use of Funds.--Amounts authorized to be appropriated under 
section 105 shall be distributed by the Coordinator of United States 
Government Activities to Combat HIV/AIDS Globally in a manner so that--
            (1) not less than 55 percent of such amounts are used for 
        activities related to the treatment of HIV with antiretroviral 
        therapies and treatment of symptoms and infections related to 
        HIV/AIDS; and
            (2) any amounts not distributed for the activities 
        described in paragraph (1) are used for other activities 
        related to the provision of care, treatment, or support 
        services for individuals affected by HIV/AIDS, including 
        children orphaned by HIV/AIDS and caregivers of such children, 
        and activities related to the preventing the transmission of 
        HIV infection, including assistance to prevent the 
such transmission from mothers to infants by providing medications and 
infant formula or other alternatives for infant feeding that prevent 
such transmission.

SEC. 103. COORDINATION WITH FOREIGN POLICY.

    Nothing contained in this Act shall be construed to infringe upon 
the powers and functions of the Secretary of State.

SEC. 104. REPORTING REQUIREMENTS.

    (a) Annual Report.--
            (1) In general.--Not later than one year after the date of 
        the enactment of this Act, and annually thereafter, the 
        Coordinator of the United States Government Activities to 
        Combat HIV/AIDS Globally shall submit to the appropriate 
        congressional committees a report on the activities of the 
        United States Government to combat the global HIV/AIDS 
        pandemic.
            (2) Content.--The report shall include the following 
        matters:
                    (A) An assessment of the progress made toward 
                implementing the strategy required by section 101.
                    (B) A discussion of the specific policies, 
                programs, and activities undertaken to implement the 
                strategy, including activities relevant to treatment 
                and to prevention of mother-to-child transmission of 
                HIV.
                    (C) An evaluation of the effectiveness of United 
                States assistance in achieving the purpose of the 
                assistance, including a discussion of any modifications 
                that should be made to the strategy required by section 
                101 to enhance its effectiveness.
                    (D) The amounts obligated, and the specific 
                programs and activities undertaken, by each relevant 
                executive branch agency to combat the global HIV/AIDS 
                pandemic, including entities receiving assistance under 
                section 104A of the Foreign Assistance Act of 1961, as 
                added by section 401(a)(2).
                    (E) The amounts of any grants awarded or funds 
                provided under a contract to nongovernmental 
                organizations (including nonprofit, community-based, or 
                faith-based organizations) by the Coordinator, pursuant 
                to section 1(f) of the State Department Basic 
                Authorities Act, as added by section 102(a)(2), and a 
                description of the use of such grants or funds.
            (3) Public dissemination.--The Coordinator shall make 
        available to the public, through electronic media and other 
        publication mechanisms, a description of the use of assistance 
        received by a person pursuant to an application approved under 
        section 104A of the Foreign Assistance Act of 1961, as added by 
        section 401(a)(2), and any grant awarded or contract entered 
        into by the Coordinator under section 1 of the State Department 
        Basic Authorities Act, as amended by section 102(a), as 
        follows:
                    (A) For an application approved, grant awarded, or 
                contract entered into during the 9-month period 
                beginning on the date of the enactment of this Act, not 
                later than one year after such date.
                    (B) For an application approved, grant awarded, or 
                contract entered into after the 9-month period 
                beginning on the date of the enactment of this Act, not 
                later than 180 days after such application is approved.
    (b) Report on Treatment Activities.--
            (1) In general.--Not later than 15 months after the date of 
        the enactment of this Act, the Coordinator of the United States 
        Government Activities to Combat HIV/AIDS Globally shall submit 
        to the appropriate congressional committees a report on the 
        programs and activities of the relevant executive branch 
        agencies that are directed to the treatment of individuals in 
        foreign countries who are infected with HIV or living with 
        AIDS.
            (2) Report elements.--The report described in paragraph (1) 
        shall include--
                    (A) a description of the activities of the relevant 
                executive branch agencies with respect to--
                            (i) the treatment of opportunistic 
                        infections;
                            (ii) the use of antiretrovirals;
                            (iii) the status of research into 
                        successful treatment protocols for individuals 
                        in the developing world; and
                            (iv) technical assistance and training of 
                        health care workers in foreign countries to 
                        administer antiretrovirals, manage side 
                        effects, and monitor patients viral loads and 
                        immune status;
                    (B) information on existing demonstration projects, 
                including for each project a discussion of the reasons 
                a given population was selected to participate in the 
                project, the number of people treated, the cost of 
                treatment, the mechanisms established to ensure that 
                treatment is being administered effectively and safely, 
                and plans, if any, for expanding the demonstration 
                project, including projected schedules and the 
                necessary resources; and
                    (C) an explanation of how the activities and 
                projects described in subparagraphs (A) and (B) relate 
                to efforts to prevent the transmission of HIV 
                infection.

SEC. 105. AUTHORIZATION OF APPROPRIATIONS.

    There are authorized to be appropriated $1,460,000,000 for fiscal 
year 2004 and $1,610,000,000 for fiscal year 2005 for United States 
Government programs and activities to combat HIV/AIDS globally, 
including activities to carry out the Emergency Plan for AIDS Relief 
announced by the President in January 2003. Funds made available under 
this section may remain available until expended.

SEC. 106. AUTHORITY TO CONSOLIDATE AND COMBINE REPORTS.

    Notwithstanding any other provision of this Act, the President may 
consolidate or combine any report provided for under this Act, other 
than the report required by section 101(c), with any other such report 
in order to ensure an efficient use of resources. The President may 
enter into contracts with organizations with relevant expertise to 
develop, originate, or contribute to any such report.

                 TITLE II--PUBLIC-PRIVATE PARTNERSHIPS

SEC. 201. SENSE OF CONGRESS REGARDING PUBLIC-PRIVATE PARTNERSHIPS.

    (a) Findings.--Congress makes the following findings:
            (1) Innovative partnerships between governments and 
        organizations in the private sector (including foundations, 
        universities, corporations, nonprofit, community-based, or 
        faith-based organizations, or other nongovernmental 
        organizations) have proliferated, particularly in the area of 
        health.
            (2) Public-private partnerships multiply local and 
        international capacities to strengthen the delivery of health 
        services in foreign countries and to accelerate research for 
        vaccines and other pharmaceutical products that are essential 
        to combat infectious diseases that can decimate populations.
            (3) Public-private partnerships maximize the unique 
        capabilities of each of the public and private sectors while 
        combining financial and other resources, scientific knowledge, 
        and expertise toward common goals which neither the public nor 
        the private sector can achieve alone.
            (4) Sustaining existing public-private partnerships and 
        building new ones are critical to the success of the 
        international community's efforts to combat HIV/AIDS and other 
        infectious diseases around the globe.
            (5) The Global Fund is a means for significantly 
        supplementing United States bilateral assistance programs by 
        funding programs and activities to combat HIV/AIDS, 
        tuberculosis, and malaria worldwide.
    (b) Sense of Congress.--It is the sense of Congress that--
            (1) the sustainment and promotion of public-private 
        partnerships should be an important element of the strategy 
        pursued by the United States to combat the HIV/AIDS pandemic 
        and other global health crises;
            (2) the United States should systematically track the 
        evolution of these partnerships and work with others in the 
        public and private sectors, including nonprofit, community-
        based, or faith-based organizations, to profile and build upon 
        partnership models that are most effective;
            (3) the United States must demonstrate leadership in 
        multilateral efforts to fight the HIV/AIDS pandemic through 
        significant financial participation in the Global Fund and 
        other public-private partnerships;
            (4) public-private partnerships should ensure that any 
        decisions of the partnerships that relate to the provision or 
        funding of health services are made in a manner that is open 
        and accountable to the public and to any governmental entity 
        that provides funding or assistance to the partnership; and
            (5) the Global Fund should continue to have independent 
        audits that employ widely acceptable auditing standards and 
        practices of contributions to the Fund.

SEC. 202. PARTICIPATION IN THE GLOBAL FUND TO FIGHT AIDS, TUBERCULOSIS 
              AND MALARIA.

    (a) Authority for United States Participation.--
            (1) United states participation.--The United States is 
        authorized to participate in the Global Fund.
            (2) Privileges and immunities.--The Global Fund shall be 
        considered a public international organization for purposes of 
        section 1 of the International Organizations Immunities Act (22 
        U.S.C. 288).
    (b) Public Dissemination.--Not later than 180 days after the date 
of the enactment of this Act, and regularly thereafter for the duration 
of the Global Fund, the Coordinator of the United States Government 
Activities to Combat HIV/AIDS Globally shall make available to the 
public, through electronic media and other publication mechanisms, the 
following documents:
            (1) Any proposal approved for funding by the Global Fund.
            (2) A list of all organizations that comprise each country 
        coordinating mechanism, as such mechanism is recognized by the 
        Global Fund.
            (3) A list of all organizations that received funds from 
        the Global Fund, including the amount of such funds received by 
        each organization.
    (c) Annual Report.--Not later than one year after the date of the 
enactment of this Act, and annually thereafter, the Coordinator of the 
United States Government Activities to Combat HIV/AIDS Globally shall 
submit to the appropriate congressional committees a report on the 
Global Fund. The report shall include, for the reporting period, the 
following elements:
            (1) Contributions pledged to or received by the Global Fund 
        (including donations from the private sector).
            (2) Efforts made by the Global Fund to increase 
        contributions from all sources other than the United States.
            (3) Programs funded by the Global Fund.
            (4) An evaluation of the effectiveness of such programs.
            (5) Recommendations regarding the adequacy of such 
        programs.
    (d) United States Financial Participation.--
            (1) Authorization of appropriations.--There are authorized 
        to be appropriated for United States contributions to the 
        Global Fund, in addition to any other amounts authorized to be 
        appropriated under any other provision of law for such purpose, 
        $1,000,000,000 for fiscal year 2004 and $1,200,000,000 for 
        fiscal year 2005.
            (2) Availability of funds.--
                    (A) Certain fiscal year 2004 funds.--Of the amount 
                authorized to be appropriated by paragraph (1) for 
                fiscal year 2004, $500,000,000 shall be available only 
                if the Global Fund receives, during the period 
                beginning on April 1, 2003, and ending on March 31, 
                2004, pledges from all donors other than the United 
                States for funding new grant proposals in an amount not 
                less than $2,000,000,000.
                    (B) Certain fiscal year 2005 funds.--Of the amount 
                authorized to be appropriated by paragraph (1) for 
                fiscal year 2005, $600,000,000 shall be available only 
                if the Global Fund receives, during the period 
                beginning on April 1, 2004, and ending on March 31, 
                2005, pledges from all donors other than the United 
                States for funding new grant proposals in an amount not 
                less than $2,400,000,000.
                    (C) Receipt of pledges before period end.--If the 
                Global Fund receives in a period described in 
                subparagraph (A) or (B) the pledges described in such 
                subparagraph in the amount required by such 
                subparagraph as of a date before the end of such 
                period, the United States contribution specified in 
                such subparagraph shall be available as of such date.
                    (D) Availability of amounts.--Amounts authorized to 
                be appropriated by paragraph (1), and available under 
                that paragraph or this paragraph, shall remain 
                available until expended.
            (3) Prior fiscal year funds.--Any unobligated balances of 
        funds made available for fiscal years 2001 and 2002 under 
        section 141 of the Global AIDS and Tuberculosis Relief Act of 
        2000 (22 U.S.C. 6841)--
                    (A) are authorized to remain available until 
                expended; and
                    (B) shall be merged with, and made available for 
                the same purposes as, the funds authorized to be 
                appropriated by paragraph (1).

SEC. 203. VOLUNTARY CONTRIBUTIONS TO INTERNATIONAL VACCINE FUNDS.

    (a) Vaccine Fund.--Section 302 of the Foreign Assistance Act of 
1961 (22 U.S.C. 2222) is amended by striking subsection (k) and 
inserting the following:
    ``(k) There are authorized to be appropriated $70,000,000 for 
fiscal year 2004 and $75,000,000 for fiscal year 2005 for United States 
contributions to the Vaccine Fund.''.
    (b) International AIDS Vaccine Initiative.--Section 302 of the 
Foreign Assistance Act of 1961 (22 U.S.C. 2222) is amended by striking 
subsection (l) and inserting the following:
    ``(l) There are authorized to be appropriated $20,000,000 for 
fiscal year 2004 and $25,000,000 for fiscal year 2005 for United States 
contributions to the International AIDS Vaccine Initiative.''.
    (c) Malaria Vaccine Initiative of the Program for Appropriate 
Technologies in Health (PATH).--Section 302 of the Foreign Assistance 
Act of 1961 (22 U.S.C. 2222) is amended by adding at the end the 
following new subsection:
    ``(m) There are authorized to be appropriated $5,000,000 for fiscal 
year 2004 and $5,000,000 for fiscal year 2005 for United States 
contributions to the Malaria Vaccine Initiative of the Program for 
Appropriate Technologies in Health (PATH) are authorized to be made 
available for that purpose.''.

                    TITLE III--MULTILATERAL EFFORTS

SEC. 301. AUTHORITY FOR DEBT RELIEF FOR QUALIFIED HIPC COUNTRIES.

    The Secretary of the Treasury should immediately commence efforts 
within the Paris Club of Official Creditors, the International Bank for 
Reconstruction and Development, the International Monetary Fund, and 
other appropriate multilateral development institutions to modify the 
Enhanced HIPC Initiative so that the amount of debt stock reduction 
approved for a country eligible for debt relief under the Enhanced HIPC 
Initiative is sufficient to reduce, for each of the first 3 years after 
the date of the enactment of this Act or the Decision Point, whichever 
is later--
            (1) the net present value of the outstanding public and 
        publicly guaranteed debt of the country to not more than 150 
        percent of the annual value of exports of the country for the 
        year preceding the Decision Point; and
            (2) the annual payments due on such public and publicly 
        guaranteed debt to not more than--
                    (A) 10 percent or, in the case of a country 
                suffering a public health crisis, five percent of the 
                amount of the annual current revenues received by the 
                country from internal resources; or
                    (B) a percentage of the gross national product, or 
                another benchmark, that will yield a result 
                substantially equivalent to that which would be 
                achieved through application of subparagraph (A).

SEC. 302. SENSE OF CONGRESS REGARDING THE ENHANCED HIPC INITIATIVE.

    (a) Sense of Congress Regarding Programs To Combat HIV/AIDS and 
Poverty.--It is the sense of Congress that a country otherwise eligible 
to receive cancellation of debt under the modifications to the Enhanced 
HIPC Initiative described in section 301 should receive such 
cancellation only if the country has agreed--
            (1) to ensure that the financial benefits of debt 
        cancellation are applied to programs to combat HIV/AIDS and 
        poverty, in particular through concrete measures to improve 
        basic services in health, education, nutrition, and other 
        development priorities, and to redress environmental 
        degradation; and
            (2) to ensure that the financial benefits of debt 
        cancellation are in addition to the higher of--
                    (A) the total amount spent by the government of 
                that country for poverty reduction for the year 
                preceding the year of the debt cancellation; or
                    (B) the amount equal to the average of the total of 
                the amounts spent annually by such government for each 
                of the 3 years preceding such year of debt 
                cancellation.
    (b) Sense of Congress Regarding Source of Financing by 
International Financial Institutions.--It is the sense of Congress 
that, in financing the objectives of the Enhanced HIPC Initiative, an 
international financial institution should give priority to using its 
own resources for such purpose.
    (c) Sense of Congress Regarding Conditions for Cancellation.--It is 
the sense of Congress that a country should not be eligible for 
cancellation of debt under modifications to the Enhanced HIPC 
Initiative described in section 301 if the government of the country--
            (1) has an excessive level of military expenditures;
            (2) has repeatedly provided support for acts of 
        international terrorism, as determined by the Secretary of 
        State under section 6(j)(1) of the Export Administration Act of 
        1979 (50 U.S.C. App. 2405(j)(1)) or section 620A(a) of the 
        Foreign Assistance Act of 1961 (22 U.S.C. 2371(a));
            (3) is failing to cooperate on international narcotics 
        control matters; or
            (4) engages in a consistent pattern of gross violations of 
        internationally recognized human rights, including violations 
        by its military or other security forces.

SEC. 303. DEFINITIONS.

    In this title:
            (1) Country suffering a public health crisis.--The term 
        ``country suffering a public health crisis'' means a country in 
        which the HIV infection rate, as reported in the most recent 
        epidemiological data for that country compiled by UNAIDS, is at 
        least five percent among women attending prenatal clinics or 
        more than 20 percent among individuals in groups with high-risk 
        behavior.
            (2) Decision point.--The term ``Decision Point'', with 
        respect to a country, means the date on which the executive 
        boards of the International Bank for Reconstruction and 
        Development and the International Monetary Fund review the debt 
        sustainability analysis for a country and determine that the 
        country is eligible for debt relief under the Enhanced HIPC 
        Initiative.
            (3) Enhanced hipc initiative.--The term ``Enhanced HIPC 
        Initiative'' means the multilateral debt initiative for heavily 
        indebted poor countries presented in the Report of G-7 Finance 
        Ministers on the Cologne Debt Initiative to the Cologne 
        Economic Summit, Cologne, held June 18-20, 1999.

SEC. 304. AUTHORIZATION OF APPROPRIATIONS.

    (a) In General.--There are authorized to be appropriated for fiscal 
year 2004 and for fiscal year 2005 such sums as may be necessary to 
carry out this title.
    (b) Availability of Funds.--Funds authorized to be appropriated 
under subsection (a) may remain available until expended.

                      TITLE IV--BILATERAL EFFORTS

SEC. 401. ASSISTANCE TO COMBAT HIV/AIDS.

    (a) Authority Under the Foreign Assistance Act of 1961.--Chapter 1 
of part I of the Foreign Assistance Act of 1961 (22 U.S.C. 2151 et 
seq.) is amended--
            (1) in section 104(c) (22 U.S.C. 2151b(c))--
                    (A) by striking paragraphs (4) through (7); and
                    (B) by adding at the end the following new 
                paragraphs:
    ``(4) Of the total amount made available to carry out this 
subsection and sections 104A, 104B, and 104C in any fiscal year, not 
more than 7 percent of such amount may be used for administrative 
expenses. Amounts available for such expenses under the preceding 
sentence shall be in addition to other amounts otherwise available for 
such purposes.
    ``(5) Section 604(a) and all regulations and administrative rules 
issued pursuant to that section do not apply to activities carried out 
under this subsection and sections 104A, 104B, and 104C.
    ``(6) Assistance made available under this subsection and sections 
104A, 104B, and 104C, and assistance made available under chapter 4 of 
part II to carry out the purposes of this subsection and sections 104A, 
104B, and 104C, may be made available in accordance with this 
subsection and such other sections notwithstanding any other provision 
of law.''; and
            (2) by inserting after section 104 the following new 
        section:

``SEC. 104A. ASSISTANCE TO COMBAT HIV/AIDS.

    ``(a) Finding.--Congress recognizes that the alarming spread of 
HIV/AIDS in countries in sub-Saharan Africa and the Caribbean region 
and other countries is a pandemic that is a major global health, 
national security, and humanitarian crisis.
    ``(b) Policy.--It is a major objective of the foreign HIV/AIDS 
assistance program of the United States to provide assistance for the 
prevention, care, treatment, and control of HIV/AIDS. The United States 
and other countries should provide assistance to countries in sub-
Saharan Africa and the Caribbean region and other countries and areas 
to control the HIV/AIDS pandemic through HIV/AIDS prevention, care, 
treatment, monitoring, and related activities, including activities 
focused on women and youth, and strategies to prevent mother-to-child 
transmission of the HIV infection.
    ``(c) Authority.--
            ``(1) In general.--Consistent with section 104(c), the 
        President is authorized to furnish assistance related to HIV/
        AIDS, on such terms and conditions as the President may 
        determine, including assistance to prevent, care for, treat, 
        and monitor HIV/AIDS, and to carry out related activities, in 
        countries in sub-Saharan Africa and the Caribbean region and in 
        other countries and areas.
            ``(2) Role of ngos.--It is the sense of Congress that the 
        President should provide an appropriate level of assistance 
        under paragraph (1) through nongovernmental organizations 
        (including nonprofit, community-based, or faith-based 
        organizations).
            ``(3) Coordination of assistance efforts.--The President 
        should coordinate the provision of assistance under paragraph 
        (1) with the provision of related assistance by the Joint 
        United Nations Programme on HIV/AIDS, the United Nations 
        Children's Fund, the World Health Organization, the United 
        Nations Development Programme, the Global Fund to Fight AIDS, 
        Tuberculosis and Malaria, and other appropriate international 
        organizations (such as the International Bank for 
        Reconstruction and Development), relevant regional multilateral 
        development institutions, national, state, and local 
        governments of foreign countries, appropriate governmental and 
        nongovernmental organizations (including nonprofit, community-
        based, or faith-based organizations), and relevant executive 
        branch agencies.
    ``(d) Activities Supported.--Assistance provided under subsection 
(c) shall, to the maximum extent practicable, be used to carry out the 
following activities:
            ``(1) Prevention.--Activities for the prevention of HIV/
        AIDS, including--
                    ``(A) education, voluntary testing, and counseling 
                programs with confidentiality protections, including--
                            ``(i) education related to avoiding sexual 
                        transmission of HIV infection, including the 
                        use of the `ABC' model (abstinence, be 
                        faithful, use condoms);
                            ``(ii) education related to avoiding 
                        nonsexual transmission of HIV infection, 
                        including education that encourages abstention 
                        from injection drug use and protection from 
                        exposure to the virus from unsafe health-
                        related injections and other unsafe medical 
                        practices; and
                            ``(iii) voluntary HIV testing using rapid 
                        testing protocols and the integration of such 
                        testing activities into health care facilities 
                        and programs;
                    ``(B) assistance to ensure a safe blood supply and 
                the safety of health care workers, including--
                            ``(i) the provision of, and training 
                        regarding, appropriate testing materials and 
                        pharmaceuticals;
                            ``(ii) training in medical injection safety 
                        procedures; and
                            ``(iii) promotion of adherence to universal 
                        precautions in medical settings;
                    ``(C) the provision of post-exposure HIV infection 
                prophylaxis to victims of rape and sexual assault and 
                in cases of occupational exposure to health care 
                workers;
                    ``(D) the provision of supplies, including test 
                kits, pharmaceuticals, and condoms;
                    ``(E) assistance provided through nongovernmental 
                organizations (including nonprofit, community-based, or 
                faith-based organizations and, particularly, 
                organizations that utilize both professionals and 
                volunteers with appropriate skills and experience) to 
                establish and implement culturally appropriate HIV/AIDS 
                education and prevention programs;
                    ``(F) programs to prevent the spread of HIV/AIDS by 
                focusing on the prevention or discouragement of rape, 
                sexual assault, prostitution, sex trafficking, the sex 
                industry, and the sexual exploitation of women;
                    ``(G) assistance to prevent transmission of HIV 
                from mothers to infants, including the provision of 
                medications and infant formula and other alternatives 
                for infant feeding to prevent such transmission;
                    ``(H) research on microbicides that prevent the 
                spread of HIV/AIDS; and
                    ``(I) bulk purchases of safe and effective 
                prevention technologies for women, and the appropriate 
                program support for introduction and distribution of 
                such technologies, and education and training on the 
                use of the technologies.
            ``(2) Care and treatment.--The treatment and care of 
        individuals with HIV/AIDS, including--
                    ``(A) assistance to establish and implement 
                programs to strengthen and broaden indigenous health 
                care delivery systems and the capacity of such systems 
                to deliver HIV/AIDS pharmaceuticals and otherwise 
                provide for the treatment of individuals with HIV/AIDS, 
                including clinical training for indigenous 
                organizations and health care providers;
                    ``(B) assistance to strengthen and expand hospice 
                and palliative care programs to assist patients 
                debilitated by HIV/AIDS, their families, and the 
                primary caregivers of such patients, including programs 
                that utilize nonprofit, community-based, or faith-based 
                organizations; and
                    ``(C) assistance for the provision of care and 
                treatment for individuals with HIV/AIDS through the 
                distribution of pharmaceuticals, including 
                antiretrovirals and other pharmaceuticals and therapies 
                for the treatment of opportunistic infections, 
                nutritional support, and other treatment modalities.
            ``(3) Monitoring.--The monitoring of programs, projects, 
        and activities carried out pursuant to paragraphs (1) and (2), 
        including--
                    ``(A) monitoring to ensure the adequacy of controls 
                established and implemented to provide HIV/AIDS 
                pharmaceuticals and other appropriate medicines to 
                individuals with HIV/AIDS; and
                    ``(B) appropriate evaluation and surveillance 
                activities.
            ``(4) Pharmaceuticals.--
                    ``(A) Procurement.--The procurement of HIV/AIDS 
                pharmaceuticals, antiviral therapies, and other 
                appropriate medicines, including medicines to treat 
                opportunistic infections.
                    ``(B) Mechanisms for quality control and 
                sustainment of supply.--The establishment of mechanisms 
                to ensure the quality of the HIV/AIDS pharmaceuticals, 
                antiretroviral therapies, and other appropriate 
                medicines, and the sustainability of the supply of such 
                pharmaceuticals, therapies, and medicines.
                    ``(C) Distribution.--The distribution of HIV/AIDS 
                pharmaceuticals, antiviral therapies, and other 
                appropriate medicines (including medicines to treat 
                opportunistic infections) to qualified national, 
                regional, or local organizations for the treatment of 
                individuals with HIV/AIDS in accordance with 
                appropriate HIV/AIDS testing and monitoring 
                requirements and treatment protocols and for the 
                prevention of mother-to-child transmission of the HIV 
                infection.
            ``(5) Related activities.--The conduct of related 
        activities, including--
                    ``(A) care and support for children who are 
                orphaned by the HIV/AIDS pandemic, including services 
                that are designed to care for orphaned children in a 
                family environment and rely on extended family members;
                    ``(B) improved infrastructure and institutional 
                capacity to develop and manage education, prevention, 
                and treatment programs, including training and the 
                resources for collecting and maintaining accurate HIV 
                surveillance data to target programs and measure the 
                effectiveness of interventions; and
                    ``(C) vaccine research and development partnership 
                programs with specific plans of action for the 
                development of a safe, effective, accessible, 
                preventive HIV vaccine for use throughout the world.
    ``(e) Definitions.--In this section:
            ``(1) AIDS.--The term `AIDS' means acquired immune 
        deficiency syndrome.
            ``(2) HIV.--The term `HIV' means the human immunodeficiency 
        virus, the pathogen that causes AIDS.
            ``(3) HIV/AIDS.--The term `HIV/AIDS' means the disease 
        characterized by HIV infection, or by HIV infection and onset 
        of AIDS.
            ``(4) Relevant executive branch agencies.--The term 
        `relevant executive branch agencies' means the Department of 
        State, the United States Agency for International Development, 
        the Department of Health and Human Services, the Department of 
        Labor, the Department of Commerce, the Department of the 
        Treasury, and the Department of Defense.''.
    (b) Availability of Funds.--
            (1) In general.--Of the funds authorized to be appropriated 
        under section 105, $750,000,000 for fiscal year 2004 and 
        $800,000,000 for fiscal year 2005 are authorized to be made 
        available to carry out section 104A of the Foreign Assistance 
        Act of 1961, as added by subsection (a).
            (2) Available until expended.--Funds made available under 
        paragraph (1) may remain available until expended.
            (3) Prior fiscal year funds.--Any unobligated balances of 
        funds made available for fiscal years 2001, 2002, and 2003 
        under section 104(c)(6) of the Foreign Assistance Act of 1961 
        (22 U.S.C. 2151b(c)(6)), as in effect immediately before the 
        date of the enactment of this Act, shall be merged with and 
        made available for the same purposes as the amounts made 
        available under paragraph (1).

SEC. 402. ASSISTANCE TO COMBAT TUBERCULOSIS.

    (a) Authority Under the Foreign Assistance Act of 1961.--Chapter 1 
of part I of the Foreign Assistance Act of 1961 (22 U.S.C. 2151 et 
seq.), as amended by section 401, is further amended by inserting after 
section 104A the following new section:

``SEC. 104B. ASSISTANCE TO COMBAT TUBERCULOSIS.

    ``(a) Findings.--Congress makes the following findings:
            ``(1) Tuberculosis and the impact its continued existence 
        has on countries that had previously controlled the disease to 
        a substantial extent is a growing international problem.
            ``(2) The means exist to control and treat tuberculosis 
        through--
                    ``(A) expanded use of the treatment strategy 
                recommended by the World Health Organization and known 
                as `Directly Observed Treatment Shortcourse'; and
                    ``(B) adequate investment in newly created 
                mechanisms to increase access to treatment, including 
                the Global Tuberculosis Drug Facility.
    ``(b) Policy.--
            ``(1) In general.--It is a major objective of the foreign 
        assistance program of the United States to control 
        tuberculosis--
                    ``(A) in those countries classified by the World 
                Health Organization as having among the highest 
                tuberculosis burden by December 31, 2005; and
                    ``(B) in all countries in which the United States 
                Agency for International Development has established 
                development programs, by December 31, 2010.
            ``(2) Control of tuberculosis defined.--For the purposes of 
        paragraph (1), the term `control', with respect to tuberculosis 
        includes--
                    ``(A) detection of at least 70 percent of the cases 
                of infectious tuberculosis; and
                    ``(B) cure of at least 85 percent of the detected 
                cases of tuberculosis.
    ``(c) Authorization.--To carry out this section and consistent with 
section 104(c), the President is authorized to furnish assistance, on 
such terms and conditions as the President determines appropriate, 
including assistance for the prevention, treatment, control, and 
elimination of tuberculosis.
    ``(d) Priority to DOTS Coverage.--In furnishing assistance under 
subsection (c), the President shall give priority to activities that 
increase the use of the Directly Observed Treatment Shortcourse 
coverage, including funding for the Global Tuberculosis Drug Facility 
and the Stop Tuberculosis Partnership.
    ``(e) Coordination.--In carrying out this section, the President 
should coordinate with the World Health Organization, the Global Fund, 
the Department of Health and Human Services, and other organizations to 
develop and implement a comprehensive tuberculosis control program.
    ``(f) Annual Report.--Not later than January 31 of each year, the 
President shall submit to the Committee on Foreign Relations of the 
Senate and the Committee on International Relations of the House of 
Representatives a report that specifies any increase in the number of 
persons treated for tuberculosis, and any increase in the number of 
tuberculosis patients cured through each program, project, and activity 
receiving United States foreign assistance for tuberculosis control 
purposes.
    ``(g) Definitions.--In this section:
            ``(1) Global fund.--The term `Global Fund' means the 
        public-private partnership known as the Global Fund to Fight 
        AIDS, Tuberculosis and Malaria that was established under the 
        laws of Switzerland in January 2002.
            ``(2) Global tuberculosis drug facility.--The term `Global 
        Tuberculosis Drug Facility' means the initiative of the Stop 
        Tuberculosis Partnership established in 2001 to increase access 
        to high-quality tuberculosis drugs and to facilitate expansion 
        of the Directly Observed Treatment Shortcourse pursuant to the 
        Amsterdam Declaration to Stop TB, adopted at Amsterdam March 
        24, 2000.
            ``(3) Stop tuberculosis partnership.--The term `Stop 
        Tuberculosis Partnership' means the partnership of the World 
        Health Organization, donors including the United States, high 
        tuberculosis burden countries, multilateral agencies, and 
        nongovernmental and technical agencies committed to taking the 
        short-term and long-term measures necessary to control and 
        eventually eliminate tuberculosis as a public health problem in 
        the world.''.
    (b) Authorization of Appropriations.--
            (1) In general.--There are authorized to be appropriated 
        $150,000,000 for fiscal year 2004 and $170,000,000 for fiscal 
        year 2005 to carry out section 104B of the Foreign Assistance 
        Act of 1961, as added by subsection (a).
            (2) Available until expended.--Funds authorized to be 
        appropriated under paragraph (1) may remain available until 
        expended.
            (3) Prior fiscal year funds.--Any unobligated balances of 
        funds made available for fiscal years 2001, 2002, and 2003 
        under section 104(c)(7) of the Foreign Assistance Act of 1961 
        (22 U.S.C. 2151b(c)(7)), as in effect immediately before the 
date of the enactment of this Act, shall be merged with and made 
available for the same purposes as the amounts authorized to be 
appropriated under paragraph (1).

SEC. 403. ASSISTANCE TO COMBAT MALARIA.

    (a) Authority Under the Foreign Assistance Act of 1961.--Chapter 1 
of part I of the Foreign Assistance Act of 1961 (22 U.S.C. 2151 et 
seq.), as amended by sections 401 and 402, is further amended by 
inserting after section 104B the following new section:

``SEC. 104C. ASSISTANCE TO COMBAT MALARIA.

    ``(a) Finding.--Congress makes the following findings:
            ``(1) Malaria kills more people annually than any other 
        communicable disease except tuberculosis.
            ``(2) More than 90 percent of all malaria cases are in sub-
        Saharan Africa.
            ``(3) Children and women have a particularly high risk of 
        contracting malaria.
            ``(4) Malaria is a curable disease if promptly diagnosed 
        and adequately treated.
            ``(5) There are cost-effective tools for decreasing the 
        spread of malaria.
    ``(b) Policy.--It is a major objective of the foreign assistance 
program of the United States to provide assistance for the prevention, 
control, and cure of malaria.
    ``(c) Authority.--To carry out this section and consistent with 
section 104(c), the President is authorized to furnish assistance, on 
such terms and conditions as the President determines appropriate, 
including assistance for the prevention, treatment, control, and 
elimination of malaria.
    ``(d) Coordination.--In carrying out this section, the President 
should coordinate with the World Health Organization, the Global Fund, 
the Department of Health and Human Services, and other organizations 
(including nonprofit, community-based, or faith-based organizations) 
with respect to the development and implementation of a comprehensive 
malaria control program.
    ``(e) Global Fund Defined.--The term `Global Fund' has the meaning 
give than term in subsection (g) of section 104B.''.
    (b) Authorization of Appropriations.--
            (1) In general.--There are authorized to be appropriated 
        $95,000,000 for fiscal year 2004 and $115,000,000 for fiscal 
        year 2005 to carry out section 104C of the Foreign Assistance 
        Act of 1961, as added by subsection (a).
            (2) Available until expended.--Funds authorized to be 
        appropriated under paragraph (1) may remain available until 
        expended.
            (3) Prior fiscal year funds.--Any unobligated balances of 
        funds made available for fiscal years 2001, 2002, and 2003 
        under section 104(c) of the Foreign Assistance Act of 1961 (22 
        U.S.C. 2151b(c)), as in effect immediately before the date of 
        the enactment of this Act, for the purpose of combatting 
        malaria shall be merged with and made available for the same 
        purposes as the amounts authorized to be appropriated under 
        paragraph (1).

SEC. 404. DEPARTMENT OF DEFENSE HIV/AIDS PREVENTION ASSISTANCE PROGRAM.

    (a) Expansion of Program.--The Secretary of Defense, with the 
approval of the Coordinator of the United States Government Activities 
to Combat HIV/AIDS Globally, is authorized to expand, in accordance 
with this section, the Department of Defense program of HIV/AIDS 
prevention educational activities that are undertaken in connection 
with the conduct of military training, military exercises, and 
humanitarian assistance activities by the United States Armed Forces.
    (b) Eligible Countries.--A country shall be eligible for activities 
under this section if the country--
            (1) is a country suffering a public health crisis; and
            (2) participates in the military-to-military contacts 
        program of the Department of Defense.
    (c) Program Activities.--The Secretary of Defense shall ensure that 
the activities under the program--
            (1) focus, to the extent practicable, on units of the Armed 
        Forces that participate in peacekeeping operations; and
            (2) include HIV/AIDS-related voluntary counseling and 
        testing and HIV/AIDS-related surveillance.
    (d) Country Suffering a Public Health Crisis Defined.--In this 
section, the term ``country suffering a public health crisis'' means a 
country that has a rapidly rising rates of incidence of HIV/AIDS or in 
which HIV/AIDS is causing significant family, community, or societal 
disruption, as determined by the Coordinator of the United States 
Government Activities to Combat HIV/AIDS Globally.

                      TITLE V--BUSINESS PRINCIPLES

SEC. 501. FINDINGS.

    Congress finds that the global spread of HIV/AIDS presents not only 
a health crisis but also a crisis in the workplace that affects--
            (1) the productivity, earning power, and longevity of 
        individual workers;
            (2) the productivity, competitiveness, and financial 
        solvency of individual businesses; and
            (3) the economic productivity and development of 
        communities and the world as a whole.

SEC. 502. SENSE OF CONGRESS REGARDING PRINCIPLES FOR UNITED STATES 
              FIRMS OPERATING IN COUNTRIES AFFECTED BY THE HIV/AIDS 
              PANDEMIC.

    It is the sense of Congress that United States firms operating in 
countries affected by the HIV/AIDS pandemic are in a position to make 
significant contributions to the United States effort to respond to the 
HIV/AIDS pandemic through the voluntary adoption of the principles and 
practices described in section 503.

SEC. 503. PRINCIPLES AND PRACTICES.

    The principles and practices referred to in section 502 are as 
follows:
            (1) The application of the same employment and health 
        policies and practices to persons infected with HIV or living 
        with AIDS as apply to persons afflicted with any other illness.
            (2) The promotion of policies and practices that eliminate 
        discrimination and stigmatization against employees on the 
        basis of real or perceived HIV/AIDS status, including policies 
        and practices that provide for--
                    (A) assessing employees on merit and ability to 
                perform;
                    (B) not subjecting employees to personal 
                discrimination or abuse; and
                    (C) imposing disciplinary measures where 
                discrimination occurs.
            (3) A prohibition on compulsory HIV/AIDS testing as a 
        condition for employment, recruitment, promotion, or career 
        development.
            (4) An assurance of the confidentiality of an employee's 
        HIV/AIDS status.
            (5) Permission for an employee with an HIV/AIDS-related 
        illness to work as long as the employee is medically fit and, 
        when no longer able to work and sick leave has been exhausted, 
        an assurance that the employment relationship is to be 
        terminated in accordance with applicable antidiscrimination and 
        labor laws and the general procedures and benefit policies of 
        the employer.
            (6) An assurance that employment practices comply, at a 
        minimum, with national and international employment and labor 
        laws and codes.
            (7) Involvement of employees and individuals infected with 
        HIV or living with AIDS, drawn from the workplace or the 
        community, in the development and assessment of HIV/AIDS 
        policies and programs for the workplace.
            (8) An offer to all employees of access to culturally 
        appropriate preventive education programs and services to 
        support those programs.
            (9) An assurance that programs offered in the workplace 
        support and are integrated into larger community-based 
        responses to the problems posed by HIV/AIDS.
            (10) Cooperation with community leaders to expand the 
        availability of treatment for employees and others infected 
        with HIV or living with AIDS.




                                                        Calendar No. 88

108th CONGRESS

  1st Session

                                S. 1009

_______________________________________________________________________

                                 A BILL

 To amend the Foreign Assistance Act of 1961 and the State Department 
   Basic Authorities Act of 1956 to increase assistance for foreign 
 countries seriously affected by HIV/AIDS, tuberculosis, and malaria, 
                        and for other purposes.

_______________________________________________________________________

                              May 8, 2003

            Read the second time and placed on the calendar