[Congressional Bills 109th Congress]
[From the U.S. Government Publishing Office]
[S. 950 Introduced in Senate (IS)]







109th CONGRESS
  1st Session
                                 S. 950

   To provide assistance to combat tuberculosis, malaria, and other 
              infectious diseases, and for other purposes.


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

                             April 28, 2005

 Mr. Brownback (for himself, Ms. Landrieu, and Mr. Inhofe) introduced 
the following bill; which was read twice and referred to the Committee 
                          on Foreign Relations

_______________________________________________________________________

                                 A BILL


 
   To provide assistance to combat tuberculosis, malaria, and other 
              infectious diseases, 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.

    This Act may be cited as the ``Elimination of Neglected Diseases 
Act of 2005'' or as the ``END Act of 2005''.

SEC. 2. ENHANCED COORDINATION AND STRATEGIC PLANNING.

    (a) Malaria and TB Response Coordinators.--Section 1 of the State 
Department Basic Authorities Act of 1956 (22 U.S.C. 2651a) is amended--
            (1) by redesignating subsection (g) as subsection (i); and
            (2) by inserting after subsection (f) the following new 
        subsections:
    ``(g) Malaria Response Coordinator.--
            ``(1) In general.--There shall be established within the 
        Department of State a Coordinator of United States Government 
        Activities to Combat Malaria Globally, who shall be appointed 
        by the President (in this subsection referred to as the 
        `Coordinator').
            ``(2) Authorities and duties; definition.--
                    ``(A) Authorities.--The Coordinator, acting through 
                such nongovernmental organizations (including faith-
                based and community-based organizations) and relevant 
                executive branch agencies as may be necessary and 
                appropriate to effect the purposes of this section, is 
                authorized--
                            ``(i) to operate internationally to carry 
                        out prevention, care, treatment, support, 
                        capacity development, and other activities for 
                        combatting malaria;
                            ``(ii) to transfer and allocate funds for 
                        combatting malaria to relevant executive branch 
                        agencies in accordance with the strategy 
                        developed under section 2(b) of the END Act of 
                        2005; and
                            ``(iii) to provide grants to, and enter 
                        into contracts with, nongovernmental 
                        organizations (including faith-based and 
                        community-based organizations) for activities 
                        to combat malaria.
                    ``(B) Duties.--
                            ``(i) In general.--The Coordinator shall 
                        have primary responsibility for the oversight 
                        and coordination of all resources and 
                        international activities of the United States 
                        Government to combat malaria, including all 
                        programs, projects, and activities of the 
                        United States Government related to malaria 
                        under the United States Leadership Against HIV/
                        AIDS, Tuberculosis, and Malaria Act of 2003 (22 
                        U.S.C. 7601 et seq.) or any amendment made by 
                        that Act.
                            ``(ii) Specific duties.--The duties of the 
                        Coordinator shall specifically include the 
                        following:
                                    ``(I) Ensuring program and policy 
                                coordination related to malaria among 
                                the relevant executive branch agencies 
                                and nongovernmental organizations, 
                                including auditing, monitoring, and 
                                evaluation of all such programs.
                                    ``(II) Ensuring that each relevant 
                                executive branch agency undertakes 
                                programs primarily in those areas where 
                                the agency has the greatest expertise, 
                                technical capabilities, and potential 
                                for success in combatting malaria.
                                    ``(III) Avoiding duplication of 
                                efforts to combat malaria.
                                    ``(IV) Ensuring coordination of 
                                relevant executive branch agency 
                                activities in the field to combat 
                                malaria.
                                    ``(V) Pursuing coordination with 
                                other countries and international 
                                organizations to combat malaria.
                                    ``(VI) Resolving policy, program, 
                                and funding disputes among the relevant 
                                executive branch agencies related to 
                                activities to combat malaria.
                                    ``(VII) Directly approving all 
                                activities of the United States, 
                                including the provision of funding, 
                                related to combatting malaria.
                                    ``(VIII) Administering the Malaria 
                                Scientific Review Board established in 
                                subsection (g) of section 104C of the 
                                Foreign Assistance Act of 1961 (22 
                                U.S.C. 2151b-4).
                                    ``(IX) Establishing due diligence 
                                criteria for all recipients of funds 
                                for malaria activities subject to the 
                                coordination and appropriate 
                                monitoring, evaluation, and audits 
                                carried out by the Coordinator 
                                necessary to assess the measurable 
                                outcomes of such activities.
                                    ``(X) Coordinating with the World 
                                Health Organization, the Global Fund to 
                                Fight AIDS, Tuberculosis and Malaria, 
                                the Department of Health and Human 
Services (the Centers for Disease Control and Prevention and the 
National Institutes of Health), and other organizations with respect to 
the development and implementation of a comprehensive malaria control 
program.
                    ``(C) Relevant executive branch agencies defined.--
                In this paragraph, 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 (including the 
                Public Health Service), and any other department or 
                agency of the United States that participates in 
                international malaria activities pursuant to the 
                authorities of such department or agency or this Act.
    ``(h) TB Response Coordinator.--
            ``(1) In general.--There shall be established within the 
        Department of State a Coordinator of United States Government 
        Activities to Combat Tuberculosis Globally, who shall be 
        appointed by the President (in this subsection referred to as 
        the `Coordinator').
            ``(2) Authorities and duties; definition.--
                    ``(A) Authorities.--The Coordinator, acting through 
                such nongovernmental organizations (including faith-
                based and community-based organizations) and relevant 
                executive branch agencies as may be necessary and 
                appropriate to effect the purposes of this section, is 
                authorized--
                            ``(i) to operate internationally to carry 
                        out prevention, care, treatment, support, 
                        capacity development, and other activities for 
                        combatting tuberculosis;
                            ``(ii) to transfer and allocate funds for 
                        combatting tuberculosis to relevant executive 
                        branch agencies in accordance with the strategy 
                        developed under section 2(c) of the END Act of 
                        2005; and
                            ``(iii) to provide grants to, and enter 
                        into contracts with, nongovernmental 
                        organizations (including faith-based and 
                        community-based organizations) to carry out 
                        activities to combat tuberculosis.
                    ``(B) Duties.--
                            ``(i) In general.--The Coordinator shall 
                        have primary responsibility for the oversight 
                        and coordination of all resources and 
                        international activities of the United States 
                        Government to combat tuberculosis, including 
                        all programs, projects, and activities of the 
                        United States Government related to 
                        tuberculosis under the United States Leadership 
                        Against HIV/AIDS, Tuberculosis, and Malaria Act 
                        of 2003 (22 U.S.C. 7601 et seq.) or any 
                        amendment made by that Act.
                            ``(ii) Specific duties.--The duties of the 
                        Coordinator shall specifically include the 
                        following:
                                    ``(I) Ensuring program and policy 
                                coordination related to tuberculosis 
                                among the relevant executive branch 
                                agencies and nongovernmental 
                                organizations, including auditing, 
                                monitoring, and evaluation of all such 
                                programs.
                                    ``(II) Ensuring that each relevant 
                                executive branch agency undertakes 
                                programs primarily in those areas where 
                                the agency has the greatest expertise, 
                                technical capabilities, and potential 
                                for success in combatting tuberculosis.
                                    ``(III) Avoiding duplication of 
                                efforts to combat tuberculosis.
                                    ``(IV) Ensuring coordination of 
                                relevant executive branch agency 
                                activities in the field to combat 
                                tuberculosis.
                                    ``(V) Pursuing coordination with 
                                other countries and international 
                                organizations to combat tuberculosis.
                                    ``(VI) Resolving policy, program, 
                                and funding disputes among the relevant 
                                executive branch agencies related to 
                                activities to combat tuberculosis.
                                    ``(VII) Directly approving all 
                                activities of the United States, 
                                including the provision of funding, 
                                related to combatting tuberculosis.
                                    ``(VIII) Establishing due diligence 
                                criteria for all recipients of funds 
                                for tuberculosis activities subject to 
                                the coordination and appropriate 
                                monitoring, evaluation, and audits 
                                carried out by the Coordinator 
                                necessary to assess the measurable 
                                outcomes of such activities.
                    ``(C) Relevant executive branch agencies defined.--
                In this paragraph, 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 (including the 
                Public Health Service), and any other department or 
                agency of the United States that participates in 
                international tuberculosis activities pursuant to the 
                authorities of such department or agency or this Act.
            ``(3) Authority to serve in multiple capacities.--An 
        individual may serve as the Coordinator of United States 
        Government Activities to Combat HIV/AIDS Globally, the 
        Coordinator of United States Government Activities to Combat 
        Malaria Globally, and the Coordinator of United States 
        Government Activities to Combat Tuberculosis Globally.''.
    (b) Strategy for Malaria.--
            (1) Requirement.--Not later than 6 months after the date of 
        enactment of this Act, the Secretary of State and the Secretary 
        of Health and Human Services shall develop a comprehensive, 
        integrated, five-year strategy to set priorities for the use of 
        United States assistance for programs to combat malaria in 
        foreign countries. If elements are included in or excluded from 
        the strategy that conflict with recommendations of the Malaria 
        Scientific Review Board, the Secretary of State and the 
        Secretary of Health and Human Services shall provide a 
        justification to Congress for such inclusion or exclusion.
            (2) Objective.--The objective of the strategy required by 
        paragraph (1) shall be to reduce the rate of infection of 
        malaria in each community in a foreign country where the United 
        States provides assistance to combat malaria.
            (3) Elements.--The strategy required by paragraph (1) 
        shall--
                    (A) assign priorities for the provision of 
                assistance to combat malaria for each agency or 
                department of the United States that provides such 
                assistance that are consistent with the mission and 
                expertise of such agency or department;
                    (B) evaluate each program to combat malaria that 
                receives assistance from the United States to determine 
                if such program is consistent with such priorities and 
                to modify or terminate any inconsistent program;
                    (C) identify priority regions and countries where 
                bilateral efforts will have the greatest impact and 
                best complement multilateral efforts and bilateral 
                programs of other donors;
                    (D) describe procedures to employ measurable 
                outcome indicators to assess the effectiveness of a 
                program to combat malaria that receives assistance from 
                the United States, including a program that is intended 
                to build capacity or provide technical assistance;
                    (E) propose methods to eliminate duplication of 
                effort of programs to combat malaria that receives 
                assistance from the United States;
                    (F) propose activities to combat malaria to be 
                assigned to each such agency or department of the 
                United States based on the clinical and scientific 
                expertise and technical capability of such agency or 
                department to carry out such activities;
                    (G) estimate the resources required by each such 
                agency or department to carry out the strategy required 
                by paragraph (1), including requests for funding to be 
                made for these purposes by the President to Congress; 
                and
                    (H) ensure that each such program is coordinated 
                and consistent with the activities of other donors to 
                combat malaria, including such activities of the Global 
                Fund to Fight AIDS, Tuberculosis and Malaria 
                established pursuant to Article 80 of the Swiss Civil 
                Code.
            (4) Consultation.--The Coordinator of United States 
        Government Activities to Combat Malaria Globally shall consult 
        with the Malaria Scientific Review Board established in 
        subsection (g) of section 104C of the Foreign Assistance Act of 
        1961 (22 U.S.C. 2151b-4), as added by section 3(b), in 
        developing the elements for the strategy related to combatting 
        malaria.
            (5) Report.--Not later than 180 days after the date of the 
        enactment of this Act, the Coordinator of United States 
        Government Activities to Combat Malaria Globally shall submit 
        to Congress a report setting forth the strategy required by 
        paragraph (1).
    (c) Strategy for Tuberculosis.--
            (1) Requirement.--The Coordinator of United States 
        Government Activities to Combat Tuberculosis Globally shall 
        develop a comprehensive, integrated, five-year strategy to set 
        priorities for the use of United States assistance for programs 
        to combat tuberculosis in foreign countries.
            (2) Objective.--The objective of the strategy required by 
        paragraph (1) shall be to reduce the rate of infection of 
        tuberculosis in each community in a foreign country where the 
        United States provides assistance to combat tuberculosis.
            (3) Elements.--The strategy required by paragraph (1) 
        shall--
                    (A) assign priorities for the provision of 
                assistance to combat tuberculosis for each agency or 
                department of the United States that provides such 
                assistance that are consistent with the mission and 
                expertise of such agency or department;
                    (B) evaluate each program to combat tuberculosis 
                that receives assistance from the United States to 
                determine if such program is consistent with such 
                priorities and to modify or terminate any inconsistent 
                program;
                    (C) identify priority regions and countries where 
                bilateral efforts will have the greatest impact and 
                best complement multilateral efforts and bilateral 
                programs of other donors;
                    (D) describe procedures to employ measurable 
                outcome indicators to assess the effectiveness of a 
                program to combat tuberculosis that receives assistance 
                from the United States, including a program that is 
                intended to build capacity or provide technical 
                assistance;
                    (E) propose methods to eliminate duplication of 
                effort of programs to combat tuberculosis that receives 
                assistance from the United States;
                    (F) propose activities to combat tuberculosis to be 
                assigned to each such agency or department of the 
                United States based on the clinical and scientific 
                expertise and technical capability of such agency or 
                department to carry out such activities;
                    (G) estimate the resources required by each such 
                agency or department to carry out the strategy required 
                by paragraph (1), including requests for funding to be 
                made for these purposes by the President to Congress; 
                and
                    (H) ensure that each such program is coordinated 
                and consistent with the activities of other donors to 
                combat tuberculosis, including such activities of the 
                Global Fund to Fight AIDS, Tuberculosis and Malaria 
                established pursuant to Article 80 of the Swiss Civil 
                Code.
            (4) Report.--Not later than 180 days after the date of the 
        enactment of this Act, the Coordinator of United States 
        Government Activities to Combat Tuberculosis Globally shall 
        submit to Congress a report setting forth the strategy required 
        by paragraph (1).

SEC. 3. ASSISTANCE TO COMBAT MALARIA.

    (a) Award of Assistance.--Section 104C of the Foreign Assistance 
Act of 1961 (22 U.S.C. 2151b-4) is amended by adding at the end the 
following new subsections:
    ``(e) Award of Assistance.--
            ``(1) In general.--The President may not enter into any 
        agreement with a person to procure assistance to combat malaria 
        except as provided in this subsection, or as described in the 
        strategy developed under section 2(b) of the END Act of 2005.
            ``(2) Definitions.--In this subsection:
                    ``(A) Agreement.--The term `agreement' means an 
                agreement to procure assistance to combat malaria.
                    ``(B) Assistance to combat malaria.--The term 
                `assistance to combat malaria' means any goods or 
                services related to the treatment or prevention of 
                malaria authorized to be provided under subsection (c).
                    ``(C) Eligible entity.--The term `eligible entity' 
                means any person that the President determines is 
                eligible to enter into an agreement under this section.
                    ``(D) Malaria scientific review board.--The term 
                `Malaria Scientific Review Board' means the Malaria 
                Scientific Review Board established under subsection 
                (g).
            ``(3) Application.--An eligible entity seeking to enter 
        into an agreement shall submit an application to the President 
        at such time and in such manner as the President may require.
            ``(4) Term of agreement.--The term of an agreement may not 
        exceed 3 years and each agreement shall provide for the annual 
        evaluation described in paragraph (8).
            ``(5) Review panels.--
                    ``(A) Authority.--The Administrator of the United 
                States Agency for International Development is 
                authorized to establish review panels as described in 
                this subparagraph to review applications for assistance 
                under this section.
                    ``(B) Membership.--A review panel shall be composed 
                of individuals selected by the President after 
                consideration of individuals recommended by the Malaria 
                Scientific Review Board.
                    ``(C) Term of service.--The term of service for a 
                member of a review panel may not exceed 1 year. An 
                individual may serve for more than 1 term but such 
                terms may not occur during consecutive years.
                    ``(D) Availability of information.--A review panel 
                shall make available--
                            ``(i) to Congress, the transcript of any 
                        meeting of the review panel upon request; and
                            ``(ii) to the public, a summary of the 
                        review and scores awarded by the review panel 
                        to each eligible entity who submitted an 
                        application under paragraph (3) upon request.
            ``(6) Selection criteria.--
                    ``(A) History and experience.--During a fiscal year 
                prior to 2009, the history and experience of an 
                eligible entity in receiving funds from the United 
                States Agency for International Development and 
                carrying out programs with such funds may not be 
                considered in awarding assistance under this section.
                    ``(B) Availability of information.--An eligible 
                entity may not be awarded assistance under this section 
                unless such entity agrees to make available to the 
                President for publication in the Federal Register and 
                on the Internet the information that the President 
                determines is appropriate.
            ``(7) Allocation of funds.--The President shall award 
        agreements for a fiscal year in a manner so that amounts made 
        available to the President for such agreements are allocated as 
        follows:
                    ``(A) Fifty percent of such amounts shall be used 
                to provide commodities used to combat malaria, 
                including pharmaceuticals, diagnostic equipment, and 
                pesticides and pesticide application equipment for use 
                with indoor residual spraying, of which--
                            ``(i) 55 percent shall be used to provide 
                        commodities associated with indoor residual 
                        spraying; and
                            ``(ii) not less than 10 percent shall be 
                        used to provide pharmaceuticals.
                    ``(B) Not more than 10 percent may be used to carry 
                out technical assistance activities.
                    ``(C) Not more than 5 percent may be used by the 
                United States for administration, travel, or other 
                indirect or overhead costs.
                    ``(D) Not more than 5 percent may be used to carry 
                out research, including basic research or operational 
                research or vaccine and therapeutic research and 
                development.
                    ``(E) The remaining amounts should be used to--
                            ``(i) support distribution of commodities 
                        purchased under subparagraph (A);
                            ``(ii) support the commodity distribution 
                        efforts of the Global Fund to Fight HIV/AIDS, 
                        Tuberculosis and Malaria;
                            ``(iii) provide rapid response to malaria 
                        epidemics that multilateral efforts may not be 
                        able to mobilize to address quickly; or
                            ``(iv) carry out other activities with 
                        measurable impact on morbidity and mortality 
                        from malaria.
            ``(8) Evaluation.--
                    ``(A) Indicators.--At the end of each 1-year period 
                during which an agreement is in effect, the President 
                shall determine whether the assistance to combat 
                malaria provided pursuant to the agreement has produced 
                a significant decrease in the following indicators:
                            ``(i) The rate of morbidity from malaria in 
                        each health district where such assistance is 
                        provided.
                            ``(ii) The rate of mortality from malaria 
                        in each health district where such assistance 
                        is provided.
                    ``(B) Conduct of evaluation.--An evaluation of the 
                assistance to combat malaria under an agreement 
                required by subparagraph (A) may be conducted by the 
                eligible entity providing such assistance or by another 
                person, as determined by the President.
                    ``(C) Health district defined.--In this paragraph, 
                the term `health district' means the jurisdiction which 
                a program to combat malaria is operated, as designed by 
                the host government.
            ``(9) Continuation.--The President may continue an 
        agreement for an additional 1-year period if the assistance to 
        combat malaria provided under the agreement has produced a 
        significant decrease in the indicators described in clauses (i) 
        and (ii) of paragraph (8)(A).
            ``(10) Revision.--
                    ``(A) In general.--If an agreement is not continued 
                under paragraph (9), the President may negotiate to 
                revise the agreement so that the assistance to combat 
                malaria provided under the modified agreement is likely 
                to result in a significant decrease in the indicators 
                described in clauses (i) and (ii) of paragraph (8)(A).
                    ``(B) Report to congress.--If the President 
                approves a revision of an agreement that at least 75 
                percent of the members of the Malaria Scientific Review 
                Board have voted to recommend not to approve, the 
                President shall submit to Congress a justification for 
                such approval.
            ``(11) Termination.--
                    ``(A) In general.--The President shall terminate an 
                agreement if such agreement--
                            ``(i) is not continued under paragraph (9) 
                        or revised under paragraph (10); or
                            ``(ii) has been revised under paragraph 
                        (10) for 2 consecutive 1-year periods and is 
                        not continued under paragraph (9) at the end of 
                        the subsequent 1-year period.
                    ``(B) Report to congress.--If the President fails 
                to terminate an agreement that at least 75 percent of 
                the members of the Malaria Scientific Review Board have 
                voted to recommend to terminate, the President shall 
                submit to Congress a justification for such failure.
            ``(12) Ineligibility.--
                    ``(A) In general.--An eligible entity who entered 
                into an agreement that is terminated under paragraph 
                (11), and any subsidiary of such entity, may not submit 
                an application for assistance under this section during 
                the 18-month period beginning on the date such 
                agreement is terminated.
                    ``(B) Renewed eligibility.--At the end of a 3-year 
                period described in subparagraph (A), such entity may 
                submit an application for eligibility to the President 
                that includes a description of actions carried out by 
                such entity to address the reasons that the agreement 
                described in subparagraph (A) was terminated.
    ``(f) Other Limitations on Assistance.--
            ``(1) Assistance for mosquito nets.--
                    ``(A) In general.--The President may not provide 
                direct or indirect assistance under this section for a 
                project to provide mosquito nets unless such project 
                will provide mosquito nets that are treated with a 
                long-lasting insecticide.
                    ``(B) Evaluations.--An eligible entity awarded 
                assistance under this section to provide mosquito nets 
                may not receive such assistance for a period of more 
                than 24 months unless at the end of such period, such 
                entity demonstrates that--
                            ``(i) not less than 60 percent of the 
                        children under the age of 5 and of women who 
                        are pregnant in each location where such entity 
                        is providing the mosquito nets are using such 
                        nets; or
                            ``(ii) not less than 80 percent of 
                        households in each such location are using such 
                        nets.
            ``(2) Assistance for pharmaceuticals.--The President may 
        not provide assistance under this section for a project to 
        provide a pharmaceutical that contains chloroquine or 
        sulfadoxine pyrimethamine to combat malaria in a country if--
                    ``(A) resistance rates to chloroquine or 
                sulfadoxine pyrimethamine, as appropriate, in such 
                country exceed 15 percent; or
                    ``(B) no data are available for such country 
                regarding the resistance rates to chloroquine or 
                sulfadoxine pyrimethamine, as appropriate.
            ``(3) Clinical and epidemiological activities.--
                    ``(A) In general.--Notwithstanding any other 
                provision of law, the President shall ensure that the 
                Secretary of Health and Human Services, acting through 
                the Director of the Centers for Disease Control and 
                Prevention, administers any assistance provided under 
                this section for--
                            ``(i) clinical or epidemiological 
                        activities to combat malaria; and
                            ``(ii) technical assistance, or other 
                        indirect support with respect to 
                        epidemiological surveillance, diagnosis, 
                        treatment, or management of malaria.
                    ``(B) Application and evaluation.--An eligible 
                entity who receives assistance described in 
                subparagraph (A) shall apply for such funds as 
                described in subsection (e) and activities carried out 
                with such assistance shall be evaluated as described in 
                paragraph (8) of such subsection.
    (b) Malaria Scientific Review Board.--Section 104C of the Foreign 
Assistance Act of 1961 (22 U.S.C. 2151b-4), as amended by subsection 
(a), is further amended by adding at the end the following new 
subsection:
    ``(g) Malaria Scientific Review Board.--
            ``(1) Establishment.--There is established the Malaria 
        Scientific Review Board (in this subsection referred to as the 
        `Board'). The Board shall be administered by the Coordinator of 
        United States Government Activities to Combat Malaria Globally 
        established under section 1(g) of the State Department Basic 
        Authorities Act of 1956.
            ``(2) Membership.--The Board shall be composed of not less 
        than 12 members as follows:
                    ``(A) The Director of the National Institutes of 
                Health of the Department of Health and Human Services 
                or the designee of such Director.
                    ``(B) The Secretary of Defense or the designee of 
                such Secretary.
                    ``(C) The Director of the Centers for Disease 
                Control and Prevention of the Department of Health and 
                Human Services or the designee of such Director.
                    ``(D) The Director of the Office of Global Health 
                Affairs of the Department of Health and Human Services 
                or the designee of such Director.
                    ``(E) The Coordinator of United States Government 
                Activities to Combat HIV/AIDS Globally appointed under 
                section 1(f) of the State Department Basic Authorities 
                Act of 1956 (22 U.S.C. 2651a(f)) or the designee of 
                such Coordinator.
                    ``(F) The Administrator of the United States Agency 
                for International Development, or the designee of such 
                Administrator.
                    ``(G) Not less than 6 individuals selected by the 
                Coordinator of the United States Government Archives to 
                Combat HIV/AIDS Globally who are not employees of the 
                United States, including experts from countries with 
                high rates of malaria prevalence.
            ``(3) Qualifications.--A member of the Board other than a 
        member described in paragraph (2)(D), shall have a doctoral 
        degree in an appropriate field of medicine or biomedical 
        science.
            ``(4) Chair.--The Chair of the Board shall rotate on an 
        annual basis among the Board members referred to in 
        subparagraphs (A), (B), and (C) of paragraph (2).
            ``(5) Duties.--The Board shall--
                    ``(A) review any solicitation made by the United 
                States to procure goods or services related to the 
                prevention or treatment of malaria;
                    ``(B) recommend individuals to serve on a review 
                panel described in subsection (e)(5);
                    ``(C) review an evaluation made under subsection 
                (e)(8);
                    ``(D) vote on whether to recommend to terminate an 
                agreement referred to in subsection (e)(1) at the end 
                of each 1-year period that such agreement is in effect;
                    ``(E) vote on whether to recommend to approve 
                proposed modifications to such an agreement if such 
                agreement will be revised under subsection (e)(10); and
                    ``(F) consult with the Coordinator of the United 
                States Government Archives to Combat HIV/AIDS Globally 
                regarding the development of the strategy required by 
                section 2(b) of the Elimination of Neglected Diseases 
                Act of 2005.
            ``(6) Personnel matters.--
                    ``(A) Compensation of members.--Each member of the 
                Board who is not an officer or employee of the Federal 
                Government shall be compensated at a rate equal to the 
                daily equivalent of the annual rate of basic pay 
                prescribed for level IV of the Executive Schedule under 
                section 5315 of title 5, United States Code, for each 
                day (including travel time) during which such member is 
                engaged in the performance of the duties of the Board. 
                All members of the Board who are officers or employees 
                of the United States shall serve without compensation 
                in addition to that received for their services as 
                officers or employees of the United States.
                    ``(B) Travel expenses.--The members of the Board 
                shall be allowed travel expenses, including per diem in 
                lieu of subsistence, at rates authorized for employees 
                of agencies under subchapter I of chapter 57 of title 
                5, United States Code, while away from their homes or 
                regular places of business in the performance of 
                services for the Board.
                    ``(C) Staff.--
                            ``(i) In general.--The Chair of the Board 
                        may, without regard to the civil service laws 
                        and regulations, appoint and terminate an 
                        executive director and such other additional 
                        personnel as may be necessary to enable the 
                        Board to perform its duties. The employment of 
                        an executive director shall be subject to 
                        confirmation by the Board.
                            ``(ii) Compensation.--The Chair of the 
                        Board may fix the compensation of the executive 
                        director and other personnel without regard to 
                        chapter 51 and subchapter III of chapter 53 of 
                        title 5, United States Code, relating to 
classification of positions and General Schedule pay rates, except that 
the rate of pay for the executive director and other personnel may not 
exceed the rate payable for level V of the Executive Schedule under 
section 5316 of such title.
                            ``(D) Detail of government employees.--Any 
                        Federal Government employee may be detailed to 
                        the Board without reimbursement, and such 
                        detail shall be without interruption or loss of 
                        civil service status or privilege.
                            ``(E) Procurement of temporary and 
                        intermittent services.--The Chair of the Board 
                        may procure temporary and intermittent services 
                        under section 3109(b) of title 5, United States 
                        Code, at rates for individuals which do not 
                        exceed the daily equivalent of the annual rate 
                        of basic pay prescribed for level V of the 
                        Executive Schedule under section 5316 of such 
                        title.''.
    (c) Repeal of Authority To Coordinate.--Section 104C of the Foreign 
Assistance Act of 1961 (22 U.S.C. 2151b-4), as amended by subsections 
(a) and (b), is further amended by striking subsection (d).

SEC. 4. ASSISTANCE TO COMBAT TUBERCULOSIS.

    (a) Priority for DOTS Coverage.--Section 104B(e) of the Foreign 
Assistance Act of 1961 (22 U.S.C. 2151b-3(e)) is amended by striking 
the second sentence and inserting ``In order to meet the requirement of 
the preceding sentence, the President shall ensure that not less than 
75 percent of the amount made available to carry out this section for a 
fiscal year is expended for antituberculosis drugs, diagnostic 
supplies, other commodities, direct patient services, and support and 
training of frontline health workers who are responsible for direct 
contact with patients and the immediate supervisors of such workers in 
diagnosis and treatment for Directly Observed Treatment Short-course 
(DOTS) coverage and treatment of multi-drug resistant tuberculosis 
using DOTS-Plus. Such amount may be used to procure pharmaceuticals 
through the multilateral procurement mechanism known as the Global 
Tuberculosis Drug Facility.''.
    (b) Award of Assistance.--Section 104B of the Foreign Assistance 
Act of 1961 (22 U.S.C. 2151b-3) is amended--
            (1) by redesignating subsection (f) as subsection (h); and
            (2) inserting after subsection (e) the following new 
        subsections:
    ``(f) Award of Assistance.--
            ``(1) In general.--The President may not enter into any 
        agreement with a person to procure assistance to combat 
        tuberculosis except as provided in this subsection.
            ``(2) Definitions.--In this subsection:
                    ``(A) Agreement.--The term `agreement' means an 
                agreement to procure assistance to combat tuberculosis.
                    ``(B) Assistance to combat tuberculosis.--The term 
                `assistance to combat tuberculosis' means any goods or 
                services related to the treatment of tuberculosis 
                authorized to be provided under subsection (c).
                    ``(C) Eligible entity.--The term `eligible entity' 
                means any person that the President determines is 
                eligible to enter into an agreement under this section.
            ``(3) Application.--An eligible entity seeking to enter 
        into an agreement shall submit an application to the President 
        at such time and in such manner as the President may require.
            ``(4) Allocation of funds.--The President shall ensure 
        agreements are awarded in a manner so that of amounts made 
        available to the President for such agreements for a fiscal 
        year--
                    ``(A) not less than 75 percent of such amounts 
                shall be used to provide direct tuberculosis diagnosis 
                and treatment services in the 22 countries that have 
                the highest prevalence or incidence rates of 
                tuberculosis, with an emphasis on providing such 
                services to individuals in regions of such countries 
                that do not have adequate medical services; and
                    ``(B) not less than 25 percent of the amounts 
                allocated under subparagraph (A) for a fiscal year 
                shall be used to provide antituberculosis medications.
            ``(5) Availability of information.--An eligible entity may 
        not be awarded assistance under this subsection unless such 
        entity agrees to make available to the President for 
        publication in the Federal Register and on the Internet the 
        information that the President determines is appropriate.
            ``(6) Evaluation.--
                    ``(A) Indicators.--At the end of each 1-year period 
                that an agreement is in effect, the President shall 
                determine whether the assistance to combat tuberculosis 
                provided pursuant to the agreement has produced a 
                significant increase in the following indicators:
                            ``(i) The rate at which individuals who 
                        have tuberculosis are accurately diagnosed.
                            ``(ii) The number of tuberculosis patients 
                        who complete DOTS.
                            ``(iii) The percentage of tuberculosis 
                        patients who begin DOTS that complete such 
                        treatment.
                            ``(iv) The percentage of tuberculosis 
                        patients who are tested for the human 
                        immunodeficiency virus (HIV) infection, if 
                        appropriate considering the HIV prevalence 
                        rates among individuals infected with 
                        tuberculosis.
                            ``(v) The percentage of patients who test 
                        positive for HIV infection who are referred 
                        successfully to HIV care or treatment, if 
                        appropriate considering the HIV prevalence 
                        rates among individuals infected with 
                        tuberculosis.
                    ``(B) Conduct of evaluation.--An evaluation of the 
                assistance to combat malaria under an agreement 
required by subparagraph (A) may be conducted by the eligible entity 
providing such assistance or by another person, including an entity of 
a government, as determined by the President.
            ``(7) Continuation.--The President may continue an 
        agreement for additional 1-year periods if the assistance to 
        combat tuberculosis provided pursuant to the agreement has 
        produced a significant increase in the indicators described in 
        clauses (i) through (v) of paragraph (6)(A).
            ``(8) Revision.--If an agreement is not continued under 
        paragraph (7), the President may negotiate to revise the 
        agreement so that the assistance to combat tuberculosis 
        provided under the modified agreement is likely to result in a 
        significant increase in the indicators described in clauses (i) 
        through (v) of paragraph (6)(A).
            ``(9) Termination.--The President shall terminate an 
        agreement if such agreement--
                    ``(A) is not continued under paragraph (7) or 
                revised under paragraph (8); or
                    ``(B) has been revised under paragraph (8) for a 1-
                year period and is not continued under paragraph (7) at 
                the end of the subsequent 1-year period.
    ``(g) Clinical and Epidemiological Activities.--
            ``(1) In general.--Notwithstanding any other provision of 
        law, the President shall ensure that the Secretary of Health 
        and Human Services, acting through the Director of the Centers 
        for Disease Control and Prevention, administers any assistance 
        provided under this section for--
                    ``(A) clinical or epidemiological activities to 
                combat tuberculosis; and
                    ``(B) technical assistance, or other indirect 
                support with respect to epidemiological surveillance, 
                diagnosis, treatment, or management of tuberculosis.
            ``(2) Application and evaluation.--An eligible entity who 
        receives assistance described in paragraph (1) shall apply for 
        such funds as described in subsection (f) and activities 
        carried out with such assistance shall be evaluated as 
        described in paragraph (6) of such subsection.''.

SEC. 5. OTHER INFECTIOUS DISEASES.

    (a) Authority To Provide Assistance.--Section 104(c)(3) of the 
Foreign Assistance Act of 1961 (22 U.S.C. 2151b(c)(3)) is amended to 
read as follows:
    ``(3) Assistance for Infectious Diseases.--
            ``(A) Finding.--Congress finds that infectious diseases are 
        responsible for the vast majority of morbidity and mortality in 
        the developing world.
            ``(B) Authority to provide assistance.--In addition to 
        authorities to provide assistance to combat the acquired immune 
        deficiency syndrome (AIDS), the human immunodeficiency virus 
        (HIV), tuberculosis, and malaria in sections 104A, 104B, and 
        104C, the Administrator of the United States Agency for 
        International Development is authorized to implement programs 
        to prevent, treat, and control other infectious diseases, 
        including leishmaniasis, African trypanosomiasis, Chagas' 
        disease, shistosomiasis, meningitis group B, acute respiratory 
        infections, infectious diarrhea, lymphatic filariasis, 
        onchocerciasis, trachoma, and intestinal parasites in 
        developing countries.
            ``(C) Allocation of funds.--The President shall ensure that 
        of amounts made available for the assistance described in 
        subparagraph (B) for a fiscal year--
                    ``(i) not less than 50 percent of such amounts 
                shall be used to provide direct immunization, 
                prevention, diagnosis, prophylaxis, or treatment to 
                patients; and
                    ``(ii) not less than 60 percent of the amounts 
                allocated under clause (i) for a fiscal year shall be 
                used to provide medicines, vaccines, diagnostic 
                equipment, micronutrient and oral rehydration 
                combination supplements, and other commodities used in 
                the delivery of immunization, prevention, diagnosis, 
                prophylaxis, and treatment for patients.
            ``(D) Availability of information.--No individual or entity 
        may not be awarded assistance to carry out a program under this 
        paragraph unless such individual or entity agrees to make 
        available to the President for publication in the Federal 
        Register and on the Internet the information that the President 
        determines is appropriate.
            ``(E) Evaluation.--A program carried out under subparagraph 
        (B) shall be evaluated by the Administrator on an annual basis 
        to determine if such program has resulted in a significant 
        reduction in the rate of morbidity and in the rate of mortality 
        attributed to an infectious disease in each location where the 
        program was implemented.
            ``(F) Revision.--The Administrator shall revise a program 
        carried out under subparagraph (B) that, at the end of a 1-year 
        period, has not resulted in significant reduction in each of 
        the rates referred to in subparagraph (E), so that the 
        assistance provided under such modified program is likely to 
        result in a significant decrease in each such rate.
            ``(G) Clinical and epidemiological activities.--
                    ``(i) In general.--Notwithstanding any other 
                provision of law, the President shall ensure that the 
                Secretary of Health and Human Services, acting through 
                the Director of the Centers for Disease Control and 
                Prevention, administers any assistance provided under 
                this section for--
                            ``(I) clinical or epidemiological 
                        activities to combat infectious diseases; and
                            ``(II) technical assistance, or other 
                        indirect support with respect to 
                        epidemiological surveillance, diagnosis, 
                        treatment, or management of infectious 
                        diseases.
                    ``(ii) Evaluation.--Any assistance described in 
                clause (i) shall be evaluated at the end of each 1-year 
                period as described in subparagraph (E).''.
    (b) Authorization of Appropriations.--There are authorized to be 
appropriated to the President for each of the fiscal years 2006 through 
2011 such sums as may be necessary to carry out section 104(c)(3) of 
the Foreign Assistance Act of 1961 (22 U.S.C. 2151b(c)(3)), as amended 
by subsection (a).

SEC. 6. ANNUAL REPORT ON HIV/AIDS, TUBERCULOSIS, AND MALARIA.

    Section 104A(e)(2)(C)(iv) of the Foreign Assistance Act of 1961 (22 
U.S.C. 2151b-2(e)(2)(C)(iv)) is amended to read as follows:
                            ``(iv) with respect to malaria, the 
                        increase in the number of people treated and 
                        the increase in number of malaria patients 
                        cured, the number of people treated with 
                        artemesinin-based combination therapy or 
                        another therapy that is more effective than 
                        such combination therapy, the number of 
                        households that received indoor residual 
                        spraying to prevent transmission of malaria 
                        through each program, project, or activity 
                        receiving United States foreign assistance for 
                        malaria control purposes, and the progress in 
                        achieving reductions in morbidity and mortality 
                        through such programs, projects, or 
                        activities.''.

SEC. 7. AVAILABILITY OF INFORMATION ON EXPENDITURES.

    Section 104(c) of the Foreign Assistance Act of 1961 (22 U.S.C. 
2151b(c)) is amended by adding after paragraph (4) the following new 
paragraph:
    ``(5) Availability of Information.--
            ``(A) Requirement for database.--The President shall make 
        publicly available through an Internet website a database of 
        information regarding any activity carried out by the Agency, 
        the Department of State, the Department of Health and Human 
        Services, or the Department of Labor, or any assistance 
        provided by the United States to a person, including an entity 
        of a government, for the purpose of providing assistance to 
        individuals in a foreign country related to any infectious 
        disease, including--
                    ``(i) the human immunodeficiency virus (HIV) and 
                the acquired immune deficiency syndrome (AIDS);
                    ``(ii) malaria;
                    ``(iii) tuberculosis;
                    ``(iv) diarrheal disease;
                    ``(v) polio; and
                    ``(vi) acute respiratory infection.
            ``(B) Information required.--The information made available 
        under subparagraph (A) for assistance provided by the United 
        State to an eligible entity, including an entity of a 
        government, shall include, for each grant of such assistance to 
        such entity--
                    ``(i) the name of such entity;
                    ``(ii) the amount of assistance received;
                    ``(iii) the text of any agreement entered into by 
                the United States and such entity, including the budget 
                proposed by such entity, the description of work to be 
                performed, and any appropriate certifications;
                    ``(iv) a description of the activities to be 
                carried out using such assistance, including the 
                location in which such activities will be carried out;
                    ``(v) the name of any person who will be 
                compensated by such entity to carry out an activity 
                described under clause (iv);
                    ``(vi) the schedule on which such assistance will 
                be provided;
                    ``(vii) progress reports on the carrying out of the 
                activities described under clause (iv); and
                    ``(viii) any reports or other products required to 
                be produced by such entity under the agreement referred 
                to in clause (iii).
            ``(C) Search capabilities.--The database developed under 
        subparagraph (A) shall be capable of being searched on multiple 
        criteria, including--
                    ``(i) disease or program area;
                    ``(ii) recipient of assistance;
                    ``(iii) country assisted;
                    ``(iv) solicitation number; or
                    ``(v) the type of activity carried out with United 
                States assistance.''.

SEC. 8. ASSISTANT SECRETARY FOR GLOBAL HEALTH.

    (a) In General.--Part P of title III of the Public Health Service 
Act (42 U.S.C. 280g et seq.) is amended by adding at the end the 
following section:

``SEC. 399O. COORDINATION OF GLOBAL HEALTH ACTIVITIES.

    ``(a) Establishment of Position of Assistant Secretary for Global 
Health.--There is established within the Department of Health and Human 
Services the position of Assistant Secretary for Global Health, who 
shall direct the Office of Global Health Affairs within the Department. 
The President shall appoint an individual to serve in such position. 
Such Assistant Secretary shall report to the Secretary.
    ``(b) Duties.--Subject to the authority of the Secretary, the 
Assistant Secretary for Global Health shall coordinate policies and 
activities of the Department that are international in nature, 
including international aspects of family and social policy, and in 
particular shall--
            ``(1) perform such interagency coordination 
        responsibilities as the Secretary has with respect to 
        international health, family, and social policy issues;
            ``(2) coordinate and lead on behalf of the Secretary--
                    ``(A) activities of the Department pertaining to 
                international and multilateral organizations; and
                    ``(B) relationships between the Department and 
                foreign governments with respect to health, family, and 
                social policy;
            ``(3) represent the Department before other Federal 
        agencies, before other governments, in international 
        organizations, and with respect to private-sector entities on 
        international health issues, refugee health issues, and 
        international aspects of other departmental issues, including 
        family and social policy;
            ``(4) provide policy guidance and coordination on refugee 
        health policy issues, in collaboration with agencies of the 
        Department and other Federal agencies;
            ``(5) coordinate technical and policy-related Federal input 
        into refugee health issues; and
            ``(6) perform such other duties as the Secretary determines 
        are appropriate.''.
    (b) Pay.--Section 5315 of title 5, United States Code, is amended 
by adding at the end the following:
            ``Assistant Secretary for Global Health, Department of 
        Health and Human Services.''.

SEC. 9. LIMITATION ON COUNTRIES THAT IMPOSE IMPORT TARIFFS.

    After the date that is 2 years after the date of the enactment of 
this Act, no agency or department of the United States may donate or 
otherwise supply medicines or medical devices, including insecticide 
treated nets, insecticides, and other essential consumables required 
for disease control to a foreign country if such country imposes import 
tariffs or other import duties on such medicines or medical devices.

SEC. 10. CONSTRUCTION.

    (a) In General.--In order for the Department of Health and Human 
Services to carry out international health activities, including 
activities related to HIV/AIDS, other infectious disease, chronic 
disease, and environmental disease, the Secretary of Health and Human 
Services may exercise authority equivalent to that available to the 
Secretary of State in section 2(c) of the State Department Basic 
Authorities Act of 1956 (22 U.S.C. 2669(c)).
    (b) Relationship with Department of State.--
            (1) Consultation.--The Secretary of Health and Human 
        Services shall consult with the Secretary of State and relevant 
        Chief of Mission to ensure that the authority provided in this 
        section is exercised in a manner consistent with section 207 of 
        the Foreign Service Act of 1980 (22 U.S.C. 3927) and other 
        applicable statutes administered by the Department of State.
            (2) Reimbursement.--The Secretary of Health and Human 
        Services is authorized to provide such funds by advance or 
        reimbursement to the Secretary of State as may be necessary to 
        pay the costs of acquisition, lease, alteration, renovation, 
        and management of facilities outside of the United States for 
        the use of the Department of Health and Human Services.
            (3) Cooperation.--The Secretary of State shall cooperate 
        fully with the Secretary of Health and Human Services to ensure 
        that the Department of Health and Human Services has secure, 
        safe, functional facilities that comply with applicable 
        regulation governing location, setback, and other facilities 
        requirements and serve the purposes established by this Act.
    (c) Renovation of Facilities.--The Secretary of Health and Human 
Services is authorized, in consultation with the Secretary of State, 
through grant or cooperative agreement, to make available to public or 
nonprofit private institutions or agencies in participating foreign 
countries, funds to acquire, lease, alter, or renovate facilities in 
those countries as necessary to conduct programs of assistance for 
international health activities, including activities relating to HIV/
AIDS, other infectious diseases, chronic diseases, and environmental 
diseases.
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