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:

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.