[Congressional Bills 110th Congress]
[From the U.S. Government Publishing Office]
[H.R. 5485 Introduced in House (IH)]







110th CONGRESS
  2d Session
                                H. R. 5485

   To establish a program to evaluate HIV/AIDS programs in order to 
improve accountability, increase transparency, and ensure the delivery 
                      of evidence-based services.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                           February 25, 2008

 Mr. Miller of North Carolina introduced the following bill; which was 
              referred to the Committee on Foreign Affairs

_______________________________________________________________________

                                 A BILL


 
   To establish a program to evaluate HIV/AIDS programs in order to 
improve accountability, increase transparency, and ensure the delivery 
                      of evidence-based services.

    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 ``PEPFAR Accountability and 
Transparency Act''.

SEC. 2. EVALUATION OF HIV/AIDS PROGRAMS.

    Subtitle A of title III of the United States Leadership Against 
HIV/AIDS, Tuberculosis, and Malaria Act of 2003 (22 U.S.C. 7631 et 
seq.) is amended by adding at the end the following:

``SEC. 308. PROGRAM MONITORING, OPERATIONS RESEARCH, AND IMPACT 
              EVALUATION RESEARCH.

    ``(a) Program Established.--The Coordinator of United States 
Government Activities to Combat HIV/AIDS Globally (referred to in this 
section as the `Coordinator') shall establish a mechanism to evaluate 
global HIV/AIDS programs financed by the United States Government in 
order to improve accountability, increase transparency, and ensure the 
delivery of evidence-based services. Such mechanism shall include 
program monitoring, operations research, and impact evaluation 
research.
    ``(b) Definitions.--In this subsection:
            ``(1) Impact evaluation research.--The term `impact 
        evaluation research' means the application of research methods 
        and statistical analysis to measure the extent to which a 
        change in a population-based outcome can be attributed to 
        program intervention instead of other environmental factors.
            ``(2) Operations research.--The term `operations research' 
        means the application of social science research methods and 
        statistical analysis to judge, compare, and improve policies 
        and program outcomes, from the earliest stages of defining and 
        designing programs through their development and 
        implementation.
            ``(3) Program monitoring.--The term `program monitoring' 
        means the collection, analysis, and use of routine program data 
        to determine how well a program is carried out and how much the 
        program costs.
            ``(4) Eligible entities.--The term `eligible entities' 
        means public or private organizations, including academic 
        institutions, that have documented experience in analyzing and 
        evaluating the effectiveness of health, development, or other 
        international aid programs.
    ``(c) Use of Funds.--The Coordinator shall use amounts provided 
under this section, either directly or indirectly through grants, 
contracts, or cooperative agreements to eligible entities, to conduct 
program monitoring, operations research, and impact evaluation research 
related to programs authorized under this Act. Such activities shall be 
conducted to--
            ``(1) improve the coverage, efficiency, effectiveness, 
        quality, and accessibility of services provided under this Act;
            ``(2) establish the cost-effectiveness of program models;
            ``(3) assess the population-level impact of programs 
        implemented, including the impact of programs on women, 
        children, and other at-risk or vulnerable populations;
            ``(4) ensure the transparency and accountability of 
        services provided under this Act;
            ``(5) disseminate and promote the utilization of evaluation 
        findings, lessons, and best practices in the implementation of 
        the programs receiving financial assistance under this Act;
            ``(6) encourage and evaluate innovative service models and 
        strategies to optimize the delivery of care, treatment, and 
        prevention programs financed by the United States Government; 
        and
            ``(7) strengthen ongoing program monitoring and enhance 
        program quality through routine program evaluations, such as 
        midterm and final program evaluations.
    ``(d) Report.--Not later than 90 days after the date of the 
enactment of the PEPFAR Accountability and Transparency Act, the 
Coordinator shall submit a report to Congress that describes the 
resources provided under this Act for program monitoring, operations 
research, and impact evaluation research during the 5-year period 
ending on September 30, 2008, that describes--
            ``(1) the projects for which resources were obligated and 
        the outcomes of those projects;
            ``(2) the program improvements, including cost or other 
        resource savings, which have been made as a result of program 
        monitoring, operations research, and impact evaluation 
        research;
            ``(3) how program monitoring, operations research, and 
        impact evaluation research priorities are determined and how 
        input from external experts is incorporated; and
            ``(4) the process used to allocate funding for 
        implementation of program monitoring, operations research, and 
        impact evaluation research.
    ``(e) Strategic Plan.--
            ``(1) In general.--Not later than 1 year after the date of 
        the enactment of the PEPFAR Accountability and Transparency 
        Act, the Coordinator shall develop a 5-year strategic plan for 
        program monitoring, operations research, and impact evaluation 
        research.
            ``(2) Plan elements.--The plan developed under this 
        subsection shall include--
                    ``(A) the amount of funding provided for program 
                monitoring, operations research, and impact evaluation 
                research under this Act available through fiscal year 
                2009;
                    ``(B) strategies to address the goals described in 
                subsection (c);
                    ``(C) priorities for program monitoring, operations 
                research, and impact evaluation research and a time 
                line for completion of activities associated with such 
                priorities; and
                    ``(D) other information that the Coordinator 
                determines to be necessary.
            ``(3) Considerations.--In developing the plan under this 
        subsection, the Coordinator shall consider a range of research 
        priorities, including research in--
                    ``(A) preventing new HIV infections by reducing 
                behavioral risks for HIV transmission, particularly in 
                at-risk and vulnerable populations, including--
                            ``(i) delaying sexual debut;
                            ``(ii) reducing the number of sexual 
                        partners;
                            ``(iii) practicing abstinence, fidelity, 
                        and monogamy;
                            ``(iv) using condoms, other effective 
                        protection methods that have been developed and 
                        are available, and female condoms; and
                            ``(v) meeting the needs of discordant 
                        couples;
                    ``(B) improving health care delivery systems and 
                HIV/AIDS-related policies;
                    ``(C) preventing mother-to-child transmission, 
                improving early identification of infected children, 
                and reducing the spread of HIV infections, particularly 
                in women and girls;
                    ``(D) reducing HIV-related mortality and morbidity 
                of HIV;
                    ``(E) treating adults and children infected by HIV 
                more effectively, including establishing better 
                approaches for increasing access to treatment and 
                increasing and sustaining treatment adherence;
                    ``(F) addressing the vulnerabilities of married and 
                unmarried women and girls to HIV infection, including 
                those who are victims of rape, sexual violence, and 
                coercion;
                    ``(G) integrating family planning into HIV/AIDS 
                prevention, care, and treatment strategies and 
                services;
                    ``(H) encouraging men to be responsible for their 
                sexual behavior and to respect women, including the 
                reduction and elimination of sexual violence and 
                coercion;
                    ``(I) developing models for scaling up HIV 
                counseling, testing with informed consent, and other 
                approaches that promote risk reduction and access to 
                care and treatment;
                    ``(J) addressing risks associated with substance 
                use;
                    ``(K) promoting the most effective models for 
                scaling up care and treatment access;
                    ``(L) ensuring a safe blood supply;
                    ``(M) improving injection safety, including 
                eliminating unnecessary injections and promoting 
                sterile injection practices and technologies;
                    ``(N) improving health care workers' occupational 
                health and safety;
                    ``(O) strengthening hospice and palliative care;
                    ``(P) scaling up the provision of prevention, care 
                and treatment services to children, including those 
                orphaned by HIV/AIDS;
                    ``(Q) preventing HIV through male circumcision; and
                    ``(R) other research that the Coordinator 
                determines to be necessary.
            ``(4) Consultation.--In developing the strategic plan and 
        implementing, disseminating, and promoting the use of program 
        monitoring, operations research, and impact evaluation 
        research, the Coordinator shall consult with representatives 
        of--
                    ``(A) the National Institutes of Health;
                    ``(B) the United States Agency for International 
                Development;
                    ``(C) the Centers for Disease Control and 
                Prevention;
                    ``(D) the Agency for Healthcare Research and 
                Quality;
                    ``(E) the Department of Health and Human Services;
                    ``(F) the Department of Labor;
                    ``(G) other Federal agencies engaged in global HIV/
                AIDS programs;
                    ``(H) multilateral structures, such as the United 
                Nations and the Global Fund To Fight AIDS, Tuberculosis 
                and Malaria;
                    ``(I) national governments of foreign countries in 
                which programs under this Act are administered;
                    ``(J) organizations implementing programmatic 
                activities under this Act; and
                    ``(K) other organizations with expertise in 
                monitoring and evaluating international HIV/AIDS 
                programs.
            ``(5) Meeting and public comment.--The Coordinator shall--
                    ``(A) not later than 180 days after the date of the 
                enactment of the PEPFAR Accountability and Transparency 
                Act, hold a public meeting at which the public may 
                present its views on the current needs and gaps in 
                program monitoring, operations research, and impact 
                evaluation research;
                    ``(B) during the 30-day period following the public 
                meeting held pursuant to subparagraph (A), collect 
                written comments from the public; and
                    ``(C) publish the comments received pursuant to 
                subparagraph (B) on the Office of the Global AIDS 
                Coordinator's Internet Web site.
            ``(6) Review of strategic plan.--The Coordinator shall--
                    ``(A) not later than 1 year after the date of the 
                enactment of the PEPFAR Accountability and Transparency 
                Act, present the strategic plan developed under this 
                subsection to the appropriate congressional committees;
                    ``(B) publish the strategic plan in the Federal 
                Register and on the Office of the Global AIDS 
                Coordinator's Internet Web site;
                    ``(C) during the 60-day period following the 
                publication of the plan under subparagraph (B), solicit 
                written comments on the plan from the public;
                    ``(D) hold a meeting at which the public is given 
                an opportunity to present its views on the plan; and
                    ``(E) after consideration of the views and comments 
                received from the public, make any necessary revisions 
                to the plan.
    ``(f) Best Practices Report.--The Coordinator shall annually 
publish a best practices report that highlights the programs that have 
the potential for translation, particularly at a low cost, across 
global AIDS programs, including those that focus on both generalized 
and localized epidemics, receiving financial assistance from the United 
States.
    ``(g) Dissemination of Findings.--
            ``(1) In general.--The Coordinator shall disseminate the 
        full findings of the multiple operations research and impact 
        evaluation research and program level monitoring efforts on the 
        Office of the Global AIDS Coordinator's Internet website in 
        order to improve transparency and public availability of 
        information about operations research and impact evaluation 
        research.
            ``(2) Dissemination guidance.--The Coordinator shall 
        develop guidance to ensure timely submission and dissemination 
        of all impact evaluation research, operations research, and 
        program monitoring findings. The time lines and processes 
        included in such guidance shall take into account the 
        publication process for peer-reviewed scientific or academic 
        journals and the discussion of such research findings at a 
        scientific meeting or any other public or private forum, so as 
        to maintain the scientific process without unduly restricting 
        dissemination of information.
    ``(h) Authorization of Appropriations.--In addition to funds made 
available under section 401(a), there are authorized to be appropriated 
such sums as may be necessary to carry out this section.''.
                                 <all>