110th CONGRESS
2d Session
H. R. 5501
In the Senate of the United
States,
July 16, 2008.
Amendment:
That the bill from the House of Representatives
(H.R. 5501) entitled An Act to authorize appropriations for fiscal years
2009 through 2013 to provide assistance to foreign countries to combat
HIV/AIDS, tuberculosis, and malaria, and for other purposes.
, do pass
with the following
Strike all after
the enacting clause and insert the
following:
1.Short title; table of contents
(a)This Act may be cited
as the Tom Lantos and Henry J. Hyde
United States Global Leadership Against HIV/AIDS, Tuberculosis, and Malaria
Reauthorization Act of 2008
.
(b)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.
Sec. 5. Authority to consolidate and combine
reports.
TITLE I—Policy Planning and
Coordination
Sec. 101. Development of an updated,
comprehensive, 5-year, global strategy.
Sec. 102. Interagency working
group.
Sec. 103. Sense of Congress.
TITLE II—Support for multilateral funds,
programs, and public-private partnerships
Sec. 201. Voluntary contributions to
international vaccine funds.
Sec. 202. Participation in the Global Fund to
Fight AIDS, Tuberculosis and Malaria.
Sec. 203. Research on methods
for women to prevent transmission of HIV and other diseases.
Sec. 204. Combating HIV/AIDS, tuberculosis, and
malaria by strengthening health policies and health systems of partner
countries.
Sec. 205. Facilitating effective operations of
the Centers for Disease Control.
Sec. 206. Facilitating vaccine
development.
TITLE III—Bilateral Efforts
Subtitle A—General Assistance and
Programs
Sec. 301. Assistance to combat
HIV/AIDS.
Sec. 302. Assistance to combat
tuberculosis.
Sec. 303. Assistance to combat
malaria.
Sec. 304. Malaria Response
Coordinator.
Sec. 305. Amendment to Immigration and
Nationality Act.
Sec. 306. Clerical amendment.
Sec. 307. Requirements.
Sec. 308. Annual report on prevention of
mother-to-child transmission of HIV.
Sec. 309. Prevention of
mother-to-child transmission expert panel.
TITLE IV—Funding allocations
Sec. 401. Authorization of
appropriations.
Sec. 402. Sense of Congress.
Sec. 403. Allocation of funds.
TITLE V—Miscellaneous
Sec. 501. Machine readable visa
fees.
TITLE VI—Emergency plan for
Indian safety and health
Sec. 601. Emergency plan for
Indian safety and health.
2.Section 2 of the
United States Leadership Against HIV/AIDS,
Tuberculosis, and Malaria Act of 2003 (22 U.S.C. 7601) is amended
by adding at the end the following:
(29)On May 27, 2003, the
President signed this Act into law, launching the largest international public
health program of its kind ever created.
(30)Between 2003 and 2008,
the United States, through the President’s Emergency Plan for AIDS Relief
(PEPFAR) and in conjunction with other bilateral programs and the multilateral
Global Fund has helped to—
(A)provide antiretroviral
therapy for over 1,900,000 people;
(B)ensure that over 150,000
infants, most of whom would have likely been infected with HIV during pregnancy
or childbirth, were not infected; and
(C)provide palliative care
and HIV prevention assistance to millions of other people.
(31)While United States
leadership in the battles against HIV/AIDS, tuberculosis, and malaria has had
an enormous impact, these diseases continue to take a terrible toll on the
human race.
(32)According to the 2007
AIDS Epidemic Update of the Joint United Nations Programme on HIV/AIDS
(UNAIDS)—
(A)an estimated 2,100,000
people died of AIDS-related causes in 2007; and
(B)an estimated 2,500,000
people were newly infected with HIV during that year.
(33)According to the World
Health Organization, malaria kills more than 1,000,000 people per year, 70
percent of whom are children under 5 years of age.
(34)According to the World
Health Organization, 1/3 of the world’s population is
infected with the tuberculosis bacterium, and tuberculosis is 1 of the greatest
infectious causes of death of adults worldwide, killing 1,600,000 people per
year.
(35)Efforts to promote
abstinence, fidelity, the correct and consistent use of condoms, the delay of
sexual debut, and the reduction of concurrent sexual partners represent
important elements of strategies to prevent the transmission of
HIV/AIDS.
(36)According to
UNAIDS—
(A)women and girls make up
nearly 60 percent of persons in sub-Saharan Africa who are HIV positive;
(B)women and girls are more
biologically, economically, and socially vulnerable to HIV infection;
and
(C)gender issues are
critical components in the effort to prevent HIV/AIDS and to care for those
affected by the disease.
(37)Children who have lost a
parent to HIV/AIDS, who are otherwise directly affected by the disease, or who
live in areas of high HIV prevalence may be vulnerable to the disease or its
socioeconomic effects.
(38)Lack of health capacity,
including insufficient personnel and inadequate infrastructure, in sub-Saharan
Africa and other regions of the world is a critical barrier that limits the
effectiveness of efforts to combat HIV/AIDS, tuberculosis, and malaria, and to
achieve other global health goals.
(39)On March 30, 2007, the
Institute of Medicine of the National Academies released a report entitled
PEPFAR Implementation: Progress and Promise
, which found that
budget allocations setting percentage levels for spending on prevention, care,
and treatment and for certain subsets of activities within the prevention
category—
(A)have adversely
affected implementation of the U.S. Global AIDS Initiative
;
(B)have inhibited
comprehensive, integrated, evidence based approaches;
(C)have been
counterproductive
;
(D)may have been
helpful initially in ensuring a balance of attention to activities within the 4
categories of prevention, treatment, care, and orphans and vulnerable
children
;
(E)have also limited
PEPFAR’s ability to tailor its activities in each country to the local epidemic
and to coordinate with the level of activities in the countries’ national
plans
; and
(F)should be removed by
Congress and replaced with more appropriate mechanisms that—
(i)ensure
accountability for results from Country Teams to the U.S. Global AIDS
Coordinator and to Congress
; and
(ii)ensure that
spending is directly linked to and commensurate with necessary efforts to
achieve both country and overall performance targets for prevention, treatment,
care, and orphans and vulnerable children
.
(40)The United States
Government has endorsed the principles of harmonization in coordinating efforts
to combat HIV/AIDS commonly referred to as the Three Ones
, which
includes—
(A)1 agreed HIV/AIDS action
framework that provides the basis for coordination of the work of all
partners;
(B)1 national HIV/AIDS
coordinating authority, with a broadbased multisectoral mandate; and
(C)1 agreed HIV/AIDS
country-level monitoring and evaluating system.
(41)In the Abuja Declaration
on HIV/AIDS, Tuberculosis and Other Related Infectious Diseases, of April
26–27, 2001 (referred to in this Act as the Abuja Declaration
),
the Heads of State and Government of the Organization of African Unity
(OAU)—
(A)declared that they would
place the fight against HIV/AIDS at the forefront and as the highest
priority issue in our respective national development plans
;
(B)committed TO TAKE
PERSONAL RESPONSIBILITY AND PROVIDE LEADERSHIP for the activities of the
National AIDS Commissions/Councils
;
(C)resolved to lead
from the front the battle against HIV/AIDS, Tuberculosis and Other Related
Infectious Diseases by personally ensuring that such bodies were properly
convened in mobilizing our societies as a whole and providing focus for unified
national policymaking and programme implementation, ensuring coordination of
all sectors at all levels with a gender perspective and respect for human
rights, particularly to ensure equal rights for people living with
HIV/AIDS
; and
(D)pledged to set a
target of allocating at least 15% of our annual budget to the improvement of
the health
sector
.
.
3.Section 3 of the
United States Leadership Against HIV/AIDS,
Tuberculosis, and Malaria Act of 2003 (22 U.S.C. 7602) is
amended—
(1)in paragraph (2), by
striking Committee on International Relations
and inserting
Committee on Foreign Affairs of the House of Representatives, the
Committee on Appropriations of the Senate, and the Committee on
Appropriations
;
(2)by redesignating
paragraph (6) as paragraph (12);
(3)by redesignating
paragraphs (3) through (5), as paragraphs (4) through (6), respectively;
(4)by inserting after
paragraph (2) the following:
(3)The term Global AIDS Coordinator means
the Coordinator of United States Government Activities to Combat HIV/AIDS
Globally.
;
and
(5)by inserting after
paragraph (6), as redesignated, the following:
(7)Impact evaluation
researchThe term impact evaluation research means
the application of research methods and statistical analysis to measure the
extent to which change in a population-based outcome can be attributed to
program intervention instead of other environmental factors.
(8)The term operations research means the
application of social science research methods, statistical analysis, and other
appropriate scientific methods to judge, compare, and improve policies and
program outcomes, from the earliest stages of defining and designing programs
through their development and implementation, with the objective of the rapid
dissemination of conclusions and concrete impact on programming.
(9)The
term paraprofessional means an individual who is trained and
employed as a health agent for the provision of basic assistance in the
identification, prevention, or treatment of illness or disability.
(10)The term partner government means a
government with which the United States is working to provide assistance to
combat HIV/AIDS, tuberculosis, or malaria on behalf of people living within the
jurisdiction of such government.
(11)The term program monitoring means the
collection, analysis, and use of routine program data to determine—
(A)how well a program is
carried out; and
(B)how much the program
costs.
.
4.Section 4 of the
United States Leadership Against HIV/AIDS,
Tuberculosis, and Malaria Act of 2003 (22 U.S.C. 7603) is amended
to read as follows:
4.The purpose of this Act is to strengthen and
enhance United States leadership and the effectiveness of the United States
response to the HIV/AIDS, tuberculosis, and malaria pandemics and other related
and preventable infectious diseases as part of the overall United States health
and development agenda by—
(1)establishing
comprehensive, coordinated, and integrated 5-year, global strategies to combat
HIV/AIDS, tuberculosis, and malaria by—
(A)building on progress and
successes to date;
(B)improving harmonization
of United States efforts with national strategies of partner governments and
other public and private entities; and
(C)emphasizing capacity
building initiatives in order to promote a transition toward greater
sustainability through the support of country-driven efforts;
(2)providing increased
resources for bilateral and multilateral efforts to fight HIV/AIDS,
tuberculosis, and malaria as integrated components of United States development
assistance;
(3)intensifying efforts
to—
(A)prevent HIV
infection;
(B)ensure the continued
support for, and expanded access to, treatment and care programs;
(C)enhance the effectiveness
of prevention, treatment, and care programs; and
(D)address the particular
vulnerabilities of girls and women;
(4)encouraging the expansion
of private sector efforts and expanding public-private sector partnerships to
combat HIV/AIDS, tuberculosis, and malaria;
(5)reinforcing efforts
to—
(A)develop safe and
effective vaccines, microbicides, and other prevention and treatment
technologies; and
(B)improve diagnostics
capabilities for HIV/AIDS, tuberculosis, and malaria; and
(6)helping partner countries
to—
(A)strengthen health
systems;
(B)expand health workforce;
and
(C)address infrastructural
weaknesses.
.
5.Authority to consolidate
and combine reportsSection 5
of the United States Leadership Against
HIV/AIDS, Tuberculosis, and Malaria Act of 2003 (22 U.S.C. 7604)
is amended by inserting , with the exception of the 5-year
strategy
before the period at the end.
<enum>I</enum><header>Policy Planning and
Coordination</header>
<section id="id2a0c5992-5819-48c7-aa9c-6c21a09c51c3"><enum>101.</enum><header>Development of an
updated, comprehensive, 5-year, global strategy</header>
<subsection id="id4a4f1b19-ff51-44ae-8f31-99c21cf4eac7"><enum>(a)</enum><header>Strategy</header><text>Section
101(a) of the <short-title>United States Leadership
Against HIV/AIDS, Tuberculosis, and Malaria Act of 2003</short-title> (22
U.S.C. 7611(a)) is amended to read as follows:</text>
<quoted-block changed="added" display-inline="no-display-inline" id="id6d07a7d9-7895-409b-8430-6a95de077c65" reported-display-style="italic" style="OLC">
<subsection id="id8a8fb726-fbda-47b2-8c41-f560ce1e0f1d"><enum>(a)</enum><header>Strategy</header><text>The
President shall establish a comprehensive, integrated, 5-year strategy to
expand and improve efforts to combat global HIV/AIDS. This strategy
shall—</text>
<paragraph id="id52e68142-cb2f-4f1d-8440-f8bbba6161b7"><enum>(1)</enum><text>further strengthen the
capability of the United States to be an effective leader of the international
campaign against this disease and strengthen the capacities of nations
experiencing HIV/AIDS epidemics to combat this disease;</text>
</paragraph><paragraph id="id0c2716d7-c319-49f5-bcce-109252de06fd"><enum>(2)</enum><text>maintain sufficient
flexibility and remain responsive to—</text>
<subparagraph id="id3000266c-f587-44cc-9436-82a02a15efae"><enum>(A)</enum><text>changes in the
epidemic;</text>
</subparagraph><subparagraph id="id0f128c8c-6298-445e-8e3c-684b0bd1b5ca"><enum>(B)</enum><text>challenges facing partner
countries in developing and implementing an effective national response;
and</text>
</subparagraph><subparagraph id="idf2a112f7-14a2-49d7-8f72-c11b405ba8f3"><enum>(C)</enum><text>evidence-based
improvements and innovations in the prevention, care, and treatment of
HIV/AIDS;</text>
</subparagraph></paragraph><paragraph id="idfd1dee51-965b-4b43-8fed-9cc85b2dea2e"><enum>(3)</enum><text>situate United States
efforts to combat HIV/AIDS, tuberculosis, and malaria within the broader United
States global health and development agenda, establishing a roadmap to link
investments in specific disease programs to the broader goals of strengthening
health systems and infrastructure and to integrate and coordinate HIV/AIDS,
tuberculosis, or malaria programs with other health or development programs, as
appropriate;</text>
</paragraph><paragraph id="id3970fec7-495d-4eea-8fb1-48a4c32be6da"><enum>(4)</enum><text>provide a plan to—</text>
<subparagraph id="id7c9d5e6f-48ba-474e-ac21-7fa5bf93f638"><enum>(A)</enum><text>prevent 12,000,000 new
HIV infections worldwide;</text>
</subparagraph><subparagraph id="idCDDEA9D9FC4146EFB38955E589FF2ADC"><enum>(B)</enum><text>support—</text>
<clause id="idBF853C2977F540C08DAD7916C0C1081A"><enum>(i)</enum><text>the increase in the
number of individuals with HIV/AIDS receiving antiretroviral treatment above
the goal established under section 402(a)(3) and increased pursuant to
paragraphs (1) through (3) of section 403(d); and</text>
</clause><clause id="id79B1FC8E3BCD4D0FA72A8C4EE049A558"><enum>(ii)</enum><text>additional treatment
through coordinated multilateral efforts;</text>
</clause></subparagraph><subparagraph id="idad489a55-d1a7-4838-bb2c-48b99062431f"><enum>(C)</enum><text>support care for
12,000,000 individuals infected with or affected by HIV/AIDS, including
5,000,000 orphans and vulnerable children affected by HIV/AIDS, with an
emphasis on promoting a comprehensive, coordinated system of services to be
integrated throughout the continuum of care;</text>
</subparagraph><subparagraph id="id5c60f9e3-b203-4a65-8e00-e5467d815574"><enum>(D)</enum><text>help partner countries in
the effort to achieve goals of 80 percent access to counseling, testing, and
treatment to prevent the transmission of HIV from mother to child, emphasizing
a continuum of care model;</text>
</subparagraph><subparagraph id="ide8d48983-b4dc-4b54-818c-ebd077b2c0ad"><enum>(E)</enum><text>help partner countries to
provide care and treatment services to children with HIV in proportion to their
percentage within the HIV-infected population in each country;</text>
</subparagraph><subparagraph id="idB04AAC5EA2ED4822A9A24C0F6E97332D"><enum>(F)</enum><text>promote preservice
training for health professionals designed to strengthen the capacity of
institutions to develop and implement policies for training health workers to
combat HIV/AIDS, tuberculosis, and malaria;</text>
</subparagraph><subparagraph id="idB69AA98371A0499BA9B414EDB84B9ECF"><enum>(G)</enum><text>equip teachers with
skills needed for HIV/AIDS prevention and support for persons with, or affected
by, HIV/AIDS;</text>
</subparagraph><subparagraph id="idE450602FF75A47D1B43F3199A4148481"><enum>(H)</enum><text>provide and share best
practices for combating HIV/AIDS with health professionals;</text>
</subparagraph><subparagraph id="id4C25EF74B1904322A02C8A6C162A75F6"><enum>(I)</enum><text>promote pediatric
HIV/AIDS training for physicians, nurses, and other health care workers,
through public-private partnerships if possible, including through the
designation, if appropriate, of centers of excellence for training in pediatric
HIV/AIDS prevention, care, and treatment in partner countries; and</text>
</subparagraph><subparagraph id="id02674C1986574DDC8592E5E1958C666E"><enum>(J)</enum><text>help partner countries to
train and support retention of health care professionals and paraprofessionals,
with the target of training and retaining at least 140,000 new health care
professionals and paraprofessionals with an emphasis on training and in country
deployment of critically needed doctors and nurses and to strengthen capacities
in developing countries, especially in sub-Saharan Africa, to deliver primary
health care with the objective of helping countries achieve staffing levels of
at least 2.3 doctors, nurses, and midwives per 1,000 population, as called for
by the World Health Organization;</text>
</subparagraph></paragraph><paragraph id="idd5971ecd-457e-477b-bc51-892653d1b616"><enum>(5)</enum><text>include multisectoral
approaches and specific strategies to treat individuals infected with HIV/AIDS
and to prevent the further transmission of HIV infections, with a particular
focus on the needs of families with children (including the prevention of
mother-to-child transmission), women, young people, orphans, and vulnerable
children;</text>
</paragraph><paragraph id="idb76ad8f0-e5a0-4503-b361-f9a6990ff6d3"><enum>(6)</enum><text>establish a timetable
with annual global treatment targets with country-level benchmarks for
antiretroviral treatment;</text>
</paragraph><paragraph id="id3f5e4738-b6c1-4511-aeb8-e0638903ff33"><enum>(7)</enum><text>expand the integration of
timely and relevant research within the prevention, care, and treatment of
HIV/AIDS;</text>
</paragraph><paragraph id="id5bddfd16-494c-4c54-b6a6-a81e8f618b8a"><enum>(8)</enum><text>include a plan for
program monitoring, operations research, and impact evaluation and for the
dissemination of a best practices report to highlight findings;</text>
</paragraph><paragraph id="id90E10C97A73F4E2BA5EE5F84FC75C3EE"><enum>(9)</enum><text>support the in-country or
intra-regional training, preferably through public-private partnerships, of
scientific investigators, managers, and other staff who are capable of
promoting the systematic uptake of clinical research findings and other
evidence-based interventions into routine practice, with the goal of improving
the quality, effectiveness, and local leadership of HIV/AIDS health
care;</text>
</paragraph><paragraph id="id562525189CC847E9AAAA1C52F67A0B11"><enum>(10)</enum><text>expand and accelerate
research on and development of HIV/AIDS prevention methods for women, including
enhancing inter-agency collaboration, staffing, and organizational
infrastructure dedicated to microbicide research;</text>
</paragraph><paragraph id="id4246b730-873a-4ff7-9dbf-331abdba82c9"><enum>(11)</enum><text>provide for consultation
with local leaders and officials to develop prevention strategies and programs
that are tailored to the unique needs of each country and community and
targeted particularly toward those most at risk of acquiring HIV
infection;</text>
</paragraph><paragraph id="idf61a3826-a47a-4f54-91c5-321e9cd43c61"><enum>(12)</enum><text>make the reduction of
HIV/AIDS behavioral risks a priority of all prevention efforts by—</text>
<subparagraph id="id4cfd3bba-b84f-496c-9238-f7e8b3d8dea9"><enum>(A)</enum><text>promoting abstinence from
sexual activity and encouraging monogamy and faithfulness;</text>
</subparagraph><subparagraph id="id4bf7de57-5b2f-4ebb-a600-85310edd8f50"><enum>(B)</enum><text>encouraging the correct
and consistent use of male and female condoms and increasing the availability
of, and access to, these commodities;</text>
</subparagraph><subparagraph id="id289e0837-abe9-449c-90fa-116b693fbd6f"><enum>(C)</enum><text>promoting the delay of
sexual debut and the reduction of multiple concurrent sexual partners;</text>
</subparagraph><subparagraph id="id805839b3-7aed-4dc1-b13e-e39993070bbc"><enum>(D)</enum><text>promoting education for
discordant couples (where an individual is infected with HIV and the other
individual is uninfected or whose status is unknown) about safer sex
practices;</text>
</subparagraph><subparagraph id="idf4561254-d200-4b4c-acc4-71dde314c251"><enum>(E)</enum><text>promoting voluntary
counseling and testing, addiction therapy, and other prevention and treatment
tools for illicit injection drug users and other substance abusers;</text>
</subparagraph><subparagraph id="idecf21bda-4b6e-4902-8d80-51063bd0d710"><enum>(F)</enum><text>educating men and boys
about the risks of procuring sex commercially and about the need to end violent
behavior toward women and girls;</text>
</subparagraph><subparagraph id="ID3aefaa8011ed43dc9b2cbf19fb804096"><enum>(G)</enum><text>supporting partner
country and community efforts to identify and address social, economic, or
cultural factors, such as migration, urbanization, conflict, gender-based
violence, lack of empowerment for women, and transportation patterns, which
directly contribute to the transmission of HIV;</text>
</subparagraph><subparagraph id="id9fafaee0-dd85-411c-b042-27f5f682f50c"><enum>(H)</enum><text>supporting comprehensive
programs to promote alternative livelihoods, safety, and social reintegration
strategies for commercial sex workers and their families;</text>
</subparagraph><subparagraph id="id63d52faf-4285-46e3-a59a-fe5dae7f9a4a"><enum>(I)</enum><text>promoting cooperation
with law enforcement to prosecute offenders of trafficking, rape, and sexual
assault crimes with the goal of eliminating such crimes; and</text>
</subparagraph><subparagraph id="ida4cf0ed1-90bf-4a72-a449-65ecea904920"><enum>(J)</enum><text>working to eliminate
rape, gender-based violence, sexual assault, and the sexual exploitation of
women and children;</text>
</subparagraph></paragraph><paragraph commented="no" id="idb10bd6f4-f17d-406f-bd84-839d7d8103a0"><enum>(13)</enum><text>include programs to
reduce the transmission of HIV, particularly addressing the heightened
vulnerabilities of women and girls to HIV in many countries; and</text>
</paragraph><paragraph id="idb454147e-b248-4c94-96bc-a5055aa396b4"><enum>(14)</enum><text>support other important
means of preventing or reducing the transmission of HIV, including—</text>
<subparagraph id="ide848270f-26a4-4558-9fc0-e25dcca415c2"><enum>(A)</enum><text>medical male
circumcision;</text>
</subparagraph><subparagraph id="id8df14443-22ab-4785-be1c-4e102c1d0d41"><enum>(B)</enum><text>the maintenance of a safe
blood supply;</text>
</subparagraph><subparagraph id="id582F3053B5E947D2B93A6B90B3CD0E44"><enum>(C)</enum><text>promoting universal
precautions in formal and informal health care settings;</text>
</subparagraph><subparagraph id="ID14f0c286d0a846848719feacee7e8a2f"><enum>(D)</enum><text>educating the public to
recognize and to avoid risks to contract HIV through blood exposures during
formal and informal health care and cosmetic services;</text>
</subparagraph><subparagraph id="ID1b2418d01b8a43a2a8569e69ad979a55"><enum>(E)</enum><text>investigating suspected
nosocomial infections to identify and stop further nosocomial transmission;
and</text>
</subparagraph><subparagraph id="id48557C753A114D45859F4A87D7029B72"><enum>(F)</enum><text>other mechanisms to
reduce the transmission of HIV;</text>
</subparagraph></paragraph><paragraph id="id87922ff2-5f5a-425f-9488-cde3499a24f5"><enum>(15)</enum><text>increase support for
prevention of mother-to-child transmission;</text>
</paragraph><paragraph id="idc3a0f460-2b6f-4a6e-8851-0dbfe5a64243"><enum>(16)</enum><text>build capacity within
the public health sector of developing countries by improving health systems
and public health infrastructure and developing indicators to measure changes
in broader public health sector capabilities;</text>
</paragraph><paragraph id="id3c1b7ada-15a8-4690-85c8-eaa157868275"><enum>(17)</enum><text>increase the
coordination of HIV/AIDS programs with development programs;</text>
</paragraph><paragraph id="idf7004057-fca8-404d-972e-75b29726c90e"><enum>(18)</enum><text>provide a framework for
expanding or developing existing or new country or regional programs,
including—</text>
<subparagraph id="idf5697e34-dded-4620-8c91-a97cdabd889b"><enum>(A)</enum><text>drafting compacts or
other agreements, as appropriate;</text>
</subparagraph><subparagraph id="idfb914cea-8eb7-4aa7-adae-b60bef6a2866"><enum>(B)</enum><text>establishing criteria and
objectives for such compacts and agreements; and</text>
</subparagraph><subparagraph id="ideb75fa82-e62b-4f7a-98af-9ffb7ff29300"><enum>(C)</enum><text>promoting
sustainability;</text>
</subparagraph></paragraph><paragraph id="id9cc8aa0f-e460-4fcf-be62-c7dcad1dcc7e"><enum>(19)</enum><text>provide a plan for
national and regional priorities for resource distribution and a global
investment plan by region;</text>
</paragraph><paragraph id="id99c6cc2b-a1a5-4f48-b970-49422b747d7d"><enum>(20)</enum><text>provide a plan to
address the immediate and ongoing needs of women and girls, which—</text>
<subparagraph id="id2a30dfed-2655-4646-bd7c-fbf6551376ea"><enum>(A)</enum><text>addresses the
vulnerabilities that contribute to their elevated risk of infection;</text>
</subparagraph><subparagraph id="id0a635d12-a8b3-4567-8180-cbd3afb65c02"><enum>(B)</enum><text>includes specific goals
and targets to address these factors;</text>
</subparagraph><subparagraph id="idb7dfb506-16d6-4940-a39c-7cd80d871b41"><enum>(C)</enum><text>provides clear guidance
to field missions to integrate gender across prevention, care, and treatment
programs;</text>
</subparagraph><subparagraph id="id6458e02b-953a-4e17-a52f-b7604f6d75b6"><enum>(D)</enum><text>sets forth
gender-specific indicators to monitor progress on outcomes and impacts of
gender programs;</text>
</subparagraph><subparagraph id="id6496b84d-1fd8-416c-8730-0d7dfa1fece5"><enum>(E)</enum><text>supports efforts in
countries in which women or orphans lack inheritance rights and other
fundamental protections to promote the passage, implementation, and enforcement
of such laws;</text>
</subparagraph><subparagraph id="idd2412f7b-ca75-4923-8dc3-893ac2980cee"><enum>(F)</enum><text>supports life skills
training, especially among women and girls, with the goal of reducing
vulnerabilities to HIV/AIDS;</text>
</subparagraph><subparagraph id="iddd1e77fc-5091-4052-98be-096d9046b3fa"><enum>(G)</enum><text>addresses and prevents
gender-based violence; and</text>
</subparagraph><subparagraph id="idc228c4e9-5493-4c9f-96ed-4ba58b9116f4"><enum>(H)</enum><text>addresses the
posttraumatic and psychosocial consequences and provides postexposure
prophylaxis protecting against HIV infection to victims of gender-based
violence and rape;</text>
</subparagraph></paragraph><paragraph id="id7F00F08202504652A41C91F55F060806"><enum>(21)</enum><text>provide a plan
to—</text>
<subparagraph id="idF9691C696FE54C0C9437E6707EADD39D"><enum>(A)</enum><text>determine the local
factors that may put men and boys at elevated risk of contracting or
transmitting HIV;</text>
</subparagraph><subparagraph id="id6D61F6C420DB41E4B2B3C0CA7E74DD74"><enum>(B)</enum><text>address male norms and
behaviors to reduce these risks, including by reducing alcohol abuse;</text>
</subparagraph><subparagraph id="id59F0BE4C69C8411A9E52FD16B8AB483D"><enum>(C)</enum><text>promote responsible male
behavior; and</text>
</subparagraph><subparagraph id="id704AAA8832084681AA9FCFB9CC9D029C"><enum>(D)</enum><text>promote male
participation and leadership at the community level in efforts to promote HIV
prevention, reduce stigma, promote participation in voluntary counseling and
testing, and provide care, treatment, and support for persons with
HIV/AIDS;</text>
</subparagraph></paragraph><paragraph id="id8cc3e3c8-6c14-4679-be21-e378b647031a"><enum>(22)</enum><text>provide a plan to
address the vulnerabilities and needs of orphans and children who are
vulnerable to, or affected by, HIV/AIDS;</text>
</paragraph><paragraph id="id42B29A1E999D45569863B31FB43AD715"><enum>(23)</enum><text>encourage partner
countries to develop health care curricula and promote access to training
tailored to individuals receiving services through, or exiting from, existing
programs geared to orphans and vulnerable children;</text>
</paragraph><paragraph id="ida9b98c59-9909-44e7-a553-98a796edc548"><enum>(24)</enum><text>provide a framework to
work with international actors and partner countries toward universal access to
HIV/AIDS prevention, treatment, and care programs, recognizing that prevention
is of particular importance;</text>
</paragraph><paragraph id="ida462249d-d12a-4cf8-93e1-44627cff4881"><enum>(25)</enum><text>enhance the coordination
of United States bilateral efforts to combat global HIV/AIDS with other major
public and private entities;</text>
</paragraph><paragraph id="id39cd9331-4668-4fec-a2f5-9c90758e19ef"><enum>(26)</enum><text>enhance the attention
given to the national strategic HIV/AIDS plans of countries receiving United
States assistance by—</text>
<subparagraph id="id7ed32131-e108-4921-a4aa-1b253d7c7033"><enum>(A)</enum><text>reviewing the planning
and programmatic decisions associated with that assistance; and</text>
</subparagraph><subparagraph id="id41ebc180-1d1a-45bd-97b7-2f690d6097b8"><enum>(B)</enum><text>helping to strengthen
such national strategies, if necessary;</text>
</subparagraph></paragraph><paragraph id="ide052090c-4a37-4118-915d-3f7eded41fcf"><enum>(27)</enum><text>support activities
described in the Global Plan to Stop TB, including—</text>
<subparagraph id="id9ee33b11-2d5e-4213-b356-cc7262822d73"><enum>(A)</enum><text>expanding and enhancing
the coverage of the Directly Observed Treatment Short-course (DOTS) in order to
treat individuals infected with tuberculosis and HIV, including multi-drug
resistant or extensively drug resistant tuberculosis; and</text>
</subparagraph><subparagraph id="id8995f227-cd2d-4753-92af-208bf619268c"><enum>(B)</enum><text>improving coordination
and integration of HIV/AIDS and tuberculosis programming;</text>
</subparagraph></paragraph><paragraph id="id4cb7ef01-ac2e-4811-89a2-3850d86b7ce5"><enum>(28)</enum><text>ensure coordination
between the Global AIDS Coordinator and the Malaria Coordinator and address
issues of comorbidity between HIV/AIDS and malaria; and</text>
</paragraph><paragraph id="id7e6f09a2-1f45-4b3d-bf83-78ab17d09aba"><enum>(29)</enum><text>include a longer term
estimate of the projected resource needs, progress toward greater
sustainability and country ownership of HIV/AIDS programs, and the anticipated
role of the United States in the global effort to combat HIV/AIDS during the
10-year period beginning on October 1,
2013.</text>
</paragraph></subsection><after-quoted-block>.</after-quoted-block></quoted-block>
</subsection><subsection id="iddd98351f-de0d-42a8-9f30-d818d0262f06"><enum>(b)</enum><header>Report</header><text>Section
101(b) of such Act (<external-xref legal-doc="usc" parsable-cite="usc/22/7611">22 U.S.C. 7611(b)</external-xref>) is amended to read as follows:</text>
<quoted-block changed="added" display-inline="no-display-inline" id="ida05bfde6-1f91-4952-85f6-7ad48441e3cf" reported-display-style="italic" style="OLC">
<subsection id="idc9fbca73-5cbd-4e9a-a281-fc30dd35ffda"><enum>(b)</enum><header>Report</header>
<paragraph id="idca88cb7b-9796-4b7b-8252-89f12184d344"><enum>(1)</enum><header>In
general</header><text>Not later than October 1, 2009, the President shall
submit a report to the appropriate congressional committees that sets forth the
strategy described in subsection (a).</text>
</paragraph><paragraph id="idb6745716-49f7-464a-8aaf-1b6f483068cb"><enum>(2)</enum><header>Contents</header><text>The
report required under paragraph (1) shall include a discussion of the following
elements:</text>
<subparagraph id="id5d0ecebb-bf40-4eae-8034-61fa0aec91cd"><enum>(A)</enum><text>The purpose, scope,
methodology, and general and specific objectives of the strategy.</text>
</subparagraph><subparagraph id="idc65bb9e2-8422-4b99-a0f7-aab3a49b018c"><enum>(B)</enum><text>The problems, risks, and
threats to the successful pursuit of the strategy.</text>
</subparagraph><subparagraph id="id4dfe8fc9-c8a9-41ab-b4ed-32b6f9786cce"><enum>(C)</enum><text>The desired goals,
objectives, activities, and outcome-related performance measures of the
strategy.</text>
</subparagraph><subparagraph id="id9db36ebc-5f58-41fc-b4a8-bdb1c2d891b1"><enum>(D)</enum><text>A description of future
costs and resources needed to carry out the strategy.</text>
</subparagraph><subparagraph id="id05c65770-4417-4a80-81fe-0339e76f8ad7"><enum>(E)</enum><text>A delineation of United
States Government roles, responsibility, and coordination mechanisms of the
strategy.</text>
</subparagraph><subparagraph id="id4f8e777a-0d2f-48a8-83f2-0efab95aa2d3"><enum>(F)</enum><text>A description of the
strategy—</text>
<clause id="id48db9534-1103-4d9d-8929-a9ae8e220997"><enum>(i)</enum><text>to promote harmonization
of United States assistance with that of other international, national, and
private actors as elucidated in the <quote>Three Ones</quote>; and</text>
</clause><clause id="id8c40dfe0-aea5-4f08-9810-77afb1d6799c"><enum>(ii)</enum><text>to address existing
challenges in harmonization and alignment.</text>
</clause></subparagraph><subparagraph id="id16ce01aa-e417-4f67-82ac-9d2b0047600c"><enum>(G)</enum><text>A description of the
manner in which the strategy will—</text>
<clause id="idde0cdebf-b380-4a76-9177-55c687fc1fff"><enum>(i)</enum><text>further the development
and implementation of the national multisectoral strategic HIV/AIDS frameworks
of partner governments; and</text>
</clause><clause id="id76aad3e0-35d7-4323-abbd-bc3c9359710e"><enum>(ii)</enum><text>enhance the centrality,
effectiveness, and sustainability of those national plans.</text>
</clause></subparagraph><subparagraph id="idbac536ca-4e3a-4751-9141-31bf19698e49"><enum>(H)</enum><text>A description of how the
strategy will seek to achieve the specific targets described in subsection (a)
and other targets, as appropriate.</text>
</subparagraph><subparagraph id="ida1cc3de3-d02e-4fcd-a3d1-857cc946cf8c"><enum>(I)</enum><text>A description of, and
rationale for, the timetable for annual global treatment targets with
country-level estimates of numbers of persons in need of antiretroviral
treatment, country-level benchmarks for United States support for assistance
for antiretroviral treatment, and numbers of persons enrolled in antiretroviral
treatment programs receiving United States support. If global benchmarks are
not achieved within the reporting period, the report shall include a
description of steps being taken to ensure that global benchmarks will be
achieved and a detailed breakdown and justification of spending priorities in
countries in which benchmarks are not being met, including a description of
other donor or national support for antiretroviral treatment in the country, if
appropriate.</text>
</subparagraph><subparagraph id="id1c5ec3e7-a72d-4fb1-b492-016e9e87fcea"><enum>(J)</enum><text>A description of how
operations research is addressed in the strategy and how such research can most
effectively be integrated into care, treatment, and prevention activities in
order to—</text>
<clause id="id0d1e70ad-4a3e-4e64-83bd-bed1ccf05a51"><enum>(i)</enum><text>improve program quality
and efficiency;</text>
</clause><clause id="id62efb755-37fd-4577-9428-d6a342a8b841"><enum>(ii)</enum><text>ascertain cost
effectiveness;</text>
</clause><clause id="idd482f3fb-cd6b-48e1-865e-0d12cb27b249"><enum>(iii)</enum><text>ensure transparency and
accountability;</text>
</clause><clause id="id477f4750-3f46-4909-aaaf-d69aee70219e"><enum>(iv)</enum><text>assess population-based
impact;</text>
</clause><clause id="id8799ba04-38e2-481f-aefc-d591f5718243"><enum>(v)</enum><text>disseminate findings and
best practices; and</text>
</clause><clause id="ide7bf7f7b-6a38-48fd-b0f2-33fff8d6b227"><enum>(vi)</enum><text>optimize delivery of
services.</text>
</clause></subparagraph><subparagraph id="id87721bbb-220e-473e-b82a-2e8b97369846"><enum>(K)</enum><text>An analysis of United
States-assisted strategies to prevent the transmission of HIV/AIDS, including
methodologies to promote abstinence, monogamy, faithfulness, the correct and
consistent use of male and female condoms, reductions in concurrent sexual
partners, and delay of sexual debut, and of intended monitoring and evaluation
approaches to measure the effectiveness of prevention programs and ensure that
they are targeted to appropriate audiences.</text>
</subparagraph><subparagraph id="ide92cbd58-2e52-4940-abda-2875ef26681f"><enum>(L)</enum><text>Within the analysis
required under subparagraph (K), an examination of additional planned means of
preventing the transmission of HIV including medical male circumcision,
maintenance of a safe blood supply, public education about risks to acquire HIV
infection from blood exposures, promotion of universal precautions,
investigation of suspected nosocomial infections and other tools.</text>
</subparagraph><subparagraph id="id37A8E1EB6105470FA0A493C41529B744"><enum>(M)</enum><text>A description of efforts
to assist partner country and community to identify and address social,
economic, or cultural factors, such as migration, urbanization, conflict,
gender-based violence, lack of empowerment for women, and transportation
patterns, which directly contribute to the transmission of HIV.</text>
</subparagraph><subparagraph id="id733cb020-bb73-4a2e-97e0-bb7a9b7fc5e4"><enum>(N)</enum><text>A description of the
specific targets, goals, and strategies developed to address the needs and
vulnerabilities of women and girls to HIV/AIDS, including—</text>
<clause id="idba70a890-6894-4687-be2a-16541d80f55b"><enum>(i)</enum><text>activities directed
toward men and boys;</text>
</clause><clause id="id5b8d6a91-f44b-4def-beb1-e442fc78d69f"><enum>(ii)</enum><text>activities to enhance
educational, microfinance, and livelihood opportunities for women and
girls;</text>
</clause><clause id="id41fdbe56-a4f5-4de5-a911-cad770f43bd1"><enum>(iii)</enum><text>activities to promote
and protect the legal empowerment of women, girls, and orphans and vulnerable
children;</text>
</clause><clause id="iddb7503d7-c709-4059-88cc-6d72dad40cb4"><enum>(iv)</enum><text>programs targeted toward
gender-based violence and sexual coercion;</text>
</clause><clause id="id92d2e76b-b039-4538-bf36-483213402f74"><enum>(v)</enum><text>strategies to meet the
particular needs of adolescents;</text>
</clause><clause id="id8899243e-eea8-430e-9b03-76fc0dc0008b"><enum>(vi)</enum><text>assistance for victims
of rape, sexual abuse, assault, exploitation, and trafficking; and</text>
</clause><clause id="id74c32a8e-2398-411b-8c61-1e4193a9c09e"><enum>(vii)</enum><text>programs to prevent
alcohol abuse.</text>
</clause></subparagraph><subparagraph id="IDcecdf31c1147487ba7159f86bceb6c29"><enum>(O)</enum><text>A description of
strategies to address male norms and behaviors that contribute to the
transmission of HIV, to promote responsible male behavior, and to promote male
participation and leadership in HIV/AIDS prevention, care, treatment, and
voluntary counseling and testing.</text>
</subparagraph><subparagraph id="idbbef13b2-be3c-4de6-8ef2-b57d01da5010"><enum>(P)</enum><text>A description of
strategies—</text>
<clause id="id06b85d17-643d-4a01-be8a-5fc8141abbb8"><enum>(i)</enum><text>to address the needs of
orphans and vulnerable children, including an analysis of—</text>
<subclause id="id5bec07b3-c909-434d-ab7d-f5175c35ed99"><enum>(I)</enum><text>factors contributing to
children’s vulnerability to HIV/AIDS; and</text>
</subclause><subclause id="ide7d0f35c-1d87-4e98-b27d-69a8b5a5d94f"><enum>(II)</enum><text>vulnerabilities caused
by the impact of HIV/AIDS on children and their families; and</text>
</subclause></clause><clause id="idc7728dc5-8b46-4cb7-897c-eac9bac9b4c2"><enum>(ii)</enum><text>in areas of higher
HIV/AIDS prevalence, to promote a community-based approach to vulnerability,
maximizing community input into determining which children participate.</text>
</clause></subparagraph><subparagraph id="id21578cb8-bae3-4cdc-a7af-7c91ba1eaf34"><enum>(Q)</enum><text>A description of
capacity-building efforts undertaken by countries themselves, including
adherents of the Abuja Declaration and an assessment of the impact of
International Monetary Fund macroeconomic and fiscal policies on national and
donor investments in health.</text>
</subparagraph><subparagraph id="id899eafcb-592b-4b4a-aa95-9a4e7ffb5d6f"><enum>(R)</enum><text>A description of the
strategy to—</text>
<clause id="iddea7f198-726e-4d1c-88b4-70d1567fbedf"><enum>(i)</enum><text>strengthen capacity
building within the public health sector;</text>
</clause><clause id="ideed3b10a-76b6-4291-bfc2-d7adcc5c03d9"><enum>(ii)</enum><text>improve health care in
those countries;</text>
</clause><clause id="id8005e1f6-b284-4ba0-b078-6943f88764ce"><enum>(iii)</enum><text>help countries to
develop and implement national health workforce strategies;</text>
</clause><clause id="ida1f830dd-c1cf-4201-b087-65de5517eea5"><enum>(iv)</enum><text>strive to achieve goals
in training, retaining, and effectively deploying health staff;</text>
</clause><clause id="id7d9c64aa-dbb3-4402-8303-a5eaf03eeed8"><enum>(v)</enum><text>promote the use of codes
of conduct for ethical recruiting practices for health care workers; and</text>
</clause><clause id="id5091afd6-e633-4fcd-8619-c45b400e99de"><enum>(vi)</enum><text>increase the
sustainability of health programs.</text>
</clause></subparagraph><subparagraph id="id98eb8cc0-65cc-4e38-a675-a4e73d5a8eed"><enum>(S)</enum><text>A description of the
criteria for selection, objectives, methodology, and structure of compacts or
other framework agreements with countries or regional organizations,
including—</text>
<clause id="idd7c76024-7e48-44e6-ac9a-da2a7decef16"><enum>(i)</enum><text>the role of civil
society;</text>
</clause><clause id="ide4d4b283-5769-4783-98df-9eec787649bc"><enum>(ii)</enum><text>the degree of
transparency;</text>
</clause><clause id="id3b49fddb-f9ed-47e6-9fdf-3547bb33dbff"><enum>(iii)</enum><text>benchmarks for success
of such compacts or agreements; and</text>
</clause><clause id="ida9182a3e-d416-42c4-b735-3e190e1fe52e"><enum>(iv)</enum><text>the relationship between
such compacts or agreements and the national HIV/AIDS and public health
strategies and commitments of partner countries.</text>
</clause></subparagraph><subparagraph id="id0b6848fb-b38e-4ef4-a475-217979727036"><enum>(T)</enum><text>A strategy to better
coordinate HIV/AIDS assistance with nutrition and food assistance
programs.</text>
</subparagraph><subparagraph id="idf352ef35-2c2f-45d1-90e1-42f050eb8d1e"><enum>(U)</enum><text>A description of
transnational or regional initiatives to combat regionalized epidemics in
highly affected areas such as the Caribbean.</text>
</subparagraph><subparagraph id="id8b52ab3c-35e3-41fa-b470-bf30c8aff2b6"><enum>(V)</enum><text>A description of planned
resource distribution and global investment by region.</text>
</subparagraph><subparagraph id="id9a97388f-c9d8-4d2e-a03e-ef50d9651681"><enum>(W)</enum><text>A description of
coordination efforts in order to better implement the Stop TB Strategy and to
address the problem of coinfection of HIV/AIDS and tuberculosis and of
projected challenges or barriers to successful implementation.</text>
</subparagraph><subparagraph id="id0657c07e-e044-41d8-9a76-91eb31f0ccd0"><enum>(X)</enum><text>A description of
coordination efforts to address malaria and comorbidity with malaria and
HIV/AIDS.</text>
</subparagraph></paragraph></subsection><after-quoted-block>.</after-quoted-block></quoted-block>
</subsection><subsection id="idff70fe34-8bcf-4dfb-9fa0-d442a548a002"><enum>(c)</enum><header>Study</header><text>Section
101(c) of such Act (<external-xref legal-doc="usc" parsable-cite="usc/22/7611">22 U.S.C. 7611(c)</external-xref>) is amended to read as follows:</text>
<quoted-block act-name="" changed="added" id="idfb9a79fb-ef1f-4fa8-99fa-7ec9db517f0d" reported-display-style="italic" style="OLC">
<subsection id="id1beac7e9-3cfc-4a2a-874f-e91076ff6c38"><enum>(c)</enum><header>Study of progress
toward achievement of policy objectives</header>
<paragraph id="ide43b398d-60dc-4d7a-bf0f-f2ccaa79c6b4"><enum>(1)</enum><header>Design and budget plan
for data evaluation</header><text>The Global AIDS Coordinator shall enter into
a contract with the Institute of Medicine of the National Academies that
provides that not later than 18 months after the date of the enactment of the
<short-title>Tom Lantos and Henry J. Hyde United States
Global Leadership Against HIV/AIDS, Tuberculosis, and Malaria Reauthorization
Act of 2008</short-title>, the Institute, in consultation with the Global AIDS
Coordinator and other relevant parties representing the public and private
sector, shall provide the Global AIDS Coordinator with a design plan and budget
for the evaluation and collection of baseline and subsequent data to address
the elements set forth in paragraph (2)(B). The Global AIDS Coordinator shall
submit the budget and design plan to the appropriate congressional
committees.</text>
</paragraph><paragraph id="idbbeada26-4126-4cac-b58d-f49d73bb4e4f"><enum>(2)</enum><header>Study</header>
<subparagraph id="idc39823f5-c57d-4bce-b681-e20726b39701"><enum>(A)</enum><header>In
general</header><text>Not later than 4 years after the date of the enactment of
the <short-title>Tom Lantos and Henry J. Hyde United
States Global Leadership Against HIV/AIDS, Tuberculosis, and Malaria
Reauthorization Act of 2008</short-title>, the Institute of Medicine of the
National Academies shall publish a study that includes—</text>
<clause id="id9b447228-187a-43a5-b69e-d88c60d01f37"><enum>(i)</enum><text>an assessment of the
performance of United States-assisted global HIV/AIDS programs; and</text>
</clause><clause id="id280f1858-fb65-4830-8d48-3b2b4b0485d4"><enum>(ii)</enum><text>an evaluation of the
impact on health of prevention, treatment, and care efforts that are supported
by United States funding, including multilateral and bilateral programs
involving joint operations.</text>
</clause></subparagraph><subparagraph id="id25ab6ebb-d76e-4487-96c7-701f837db924"><enum>(B)</enum><header>Content</header><text>The
study conducted under this paragraph shall include—</text>
<clause id="id3e22c13a-0acb-4135-a5ba-8968b428dc61"><enum>(i)</enum><text>an assessment of progress
toward prevention, treatment, and care targets;</text>
</clause><clause id="idd24c336f-37de-4ca0-b12b-7a96c2a5613d"><enum>(ii)</enum><text>an assessment of the
effects on health systems, including on the financing and management of health
systems and the quality of service delivery and staffing;</text>
</clause><clause id="id941c94c5-0e91-41b6-b852-bf476e32a9c5"><enum>(iii)</enum><text>an assessment of
efforts to address gender-specific aspects of HIV/AIDS, including gender
related constraints to accessing services and addressing underlying social and
economic vulnerabilities of women and men;</text>
</clause><clause id="id568f7730-b80a-47ca-a265-3eb7b26a2fc1"><enum>(iv)</enum><text>an evaluation of the
impact of treatment and care programs on 5-year survival rates, drug adherence,
and the emergence of drug resistance;</text>
</clause><clause id="id36d5ec50-c420-4532-834a-3d0390f866c7"><enum>(v)</enum><text>an evaluation of the
impact of prevention programs on HIV incidence in relevant population
groups;</text>
</clause><clause id="id4704f774-9585-44de-ad14-e5ed9981cdcd"><enum>(vi)</enum><text>an evaluation of the
impact on child health and welfare of interventions authorized under this Act
on behalf of orphans and vulnerable children;</text>
</clause><clause id="id2ac71563-9417-4032-a29d-27a090564d9d"><enum>(vii)</enum><text>an evaluation of the
impact of programs and activities authorized in this Act on child mortality;
and</text>
</clause><clause commented="no" display-inline="no-display-inline" id="id73ea084f-1502-4456-9425-be43e1f74559"><enum>(viii)</enum><text>recommendations for
improving the programs referred to in subparagraph (A)(i).</text>
</clause></subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="id1f0d7302-c036-4a8b-8ed5-44dad397d8e1"><enum>(C)</enum><header>Methodologies</header><text>Assessments
and impact evaluations conducted under the study shall utilize sound
statistical methods and techniques for the behavioral sciences, including
random assignment methodologies as feasible. Qualitative data on process
variables should be used for assessments and impact evaluations, wherever
possible.</text>
</subparagraph></paragraph><paragraph id="id53ec547a-4d76-42aa-8a72-b780f4ec0efa"><enum>(3)</enum><header>Contract
authority</header><text>The Institute of Medicine may enter into contracts or
cooperative agreements or award grants to conduct the study under paragraph
(2).</text>
</paragraph><paragraph id="idfced8a80-0673-4215-b332-c8b1bc393523"><enum>(4)</enum><header>Authorization of
appropriations</header><text>There are authorized to be appropriated such sums
as may be necessary to carry out the study under this
subsection.</text>
</paragraph></subsection><after-quoted-block>.</after-quoted-block></quoted-block>
</subsection><subsection id="idfe650028-8220-4e21-ac64-6b30aa778094"><enum>(d)</enum><header>Report</header><text>Section
101 of such Act, as amended by this section, is further amended by adding at
the end the following:</text>
<quoted-block act-name="" changed="added" id="id16a6b212-cfa8-4f00-abc6-1ff29c335552" reported-display-style="italic" style="OLC">
<subsection id="id2c7799ca-6b2f-4c16-a1af-20c5bc34ec26"><enum>(d)</enum><header>Comptroller General
report</header>
<paragraph id="ida7a360d0-cd1f-4993-9d94-f129f002a346"><enum>(1)</enum><header>Report
Required</header><text>Not later than 3 years after the date of the enactment
of the <short-title>Tom Lantos and Henry J. Hyde United
States Global Leadership Against HIV/AIDS, Tuberculosis, and Malaria
Reauthorization Act of 2008</short-title>, the Comptroller General of the
United States shall submit a report on the global HIV/AIDS programs of the
United States to the appropriate congressional committees.</text>
</paragraph><paragraph id="idd3ec55cb-724a-4853-97b1-bf5313a4184b"><enum>(2)</enum><header>Contents</header><text>The
report required under paragraph (1) shall include—</text>
<subparagraph id="idcbee82e0-ec14-4947-bb6f-6c1540553d05"><enum>(A)</enum><text>a description and
assessment of the monitoring and evaluation practices and policies in place for
these programs;</text>
</subparagraph><subparagraph id="idd21cfcce-3d8c-4866-8666-a64b343d4b94"><enum>(B)</enum><text>an assessment of
coordination within Federal agencies involved in these programs, examining both
internal coordination within these programs and integration with the larger
global health and development agenda of the United States;</text>
</subparagraph><subparagraph id="idd593af4c-29d8-4355-869b-b3b2f55fb26a"><enum>(C)</enum><text>an assessment of
procurement policies and practices within these programs;</text>
</subparagraph><subparagraph id="ide573a3d9-4351-48d7-8546-4aace340d7f1"><enum>(D)</enum><text>an assessment of
harmonization with national government HIV/AIDS and public health strategies as
well as other international efforts;</text>
</subparagraph><subparagraph id="id44b4a13e-025a-4add-aefc-3983afa69bf4"><enum>(E)</enum><text>an assessment of the
impact of global HIV/AIDS funding and programs on other United States global
health programming; and</text>
</subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="id1cb47b13-cbe4-4c32-98ca-de9d3151730a"><enum>(F)</enum><text>recommendations for
improving the global HIV/AIDS programs of the United States.</text>
</subparagraph></paragraph></subsection><subsection id="id66f6c040-9989-4105-a1dc-5a6bf10f9c2f"><enum>(e)</enum><header>Best practices
report</header>
<paragraph id="id91e33ba6-3a1c-4872-8193-a15a3a231279"><enum>(1)</enum><header>In
general</header><text>Not later than 1 year after the date of the enactment of
the <short-title>Tom Lantos and Henry J. Hyde United
States Global Leadership Against HIV/AIDS, Tuberculosis, and Malaria
Reauthorization Act of 2008</short-title>, and annually thereafter, the Global
AIDS Coordinator shall publish a best practices report that highlights the
programs receiving financial assistance from the United States that have the
potential for replication or adaption, particularly at a low cost, across
global AIDS programs, including those that focus on both generalized and
localized epidemics.</text>
</paragraph><paragraph id="id4265daa6-44ec-440d-9614-ca785149aba2"><enum>(2)</enum><header>Dissemination of
findings</header>
<subparagraph id="idee3ffc5d-07b5-48a9-96ab-4ac3211196a5"><enum>(A)</enum><header>Publication on Internet
website</header><text>The Global AIDS Coordinator shall disseminate the full
findings of the annual best practices report on the Internet website of the
Office of the Global AIDS Coordinator.</text>
</subparagraph><subparagraph id="id90044c9f-e625-4688-a37a-7b001a888054"><enum>(B)</enum><header>Dissemination
guidance</header><text>The Global AIDS Coordinator shall develop guidance to
ensure timely submission and dissemination of significant information regarding
best practices with respect to global AIDS programs.</text>
</subparagraph></paragraph></subsection><subsection id="id38a57740-c7f0-403c-b867-6b8c8c893e67"><enum>(f)</enum><header>Inspectors
general</header>
<paragraph id="id9a31b0f5-4c8d-48bf-bee9-19072b769aec"><enum>(1)</enum><header>Oversight plan</header>
<subparagraph id="id98c0f5a8-f142-46e8-843f-09f7746f7b68"><enum>(A)</enum><header>Development</header><text>The
Inspectors General of the Department of State and Broadcasting Board of
Governors, the Department of Health and Human Services, and the United States
Agency for International Development shall jointly develop 5 coordinated annual
plans for oversight activity in each of the fiscal years 2009 through 2013,
with regard to the programs authorized under this Act and sections 104A, 104B,
and 104C of the Foreign Assistance Act of 1961 (<external-xref legal-doc="usc" parsable-cite="usc/22/2151b-2">22 U.S.C. 2151b–2</external-xref>, 2151b–3, and
2151b–4).</text>
</subparagraph><subparagraph id="id2fbff8ce-2dc7-418c-81f8-9000d84914d7"><enum>(B)</enum><header>Contents</header><text>The
plans developed under subparagraph (A) shall include a schedule for financial
audits, inspections, and performance reviews, as appropriate.</text>
</subparagraph><subparagraph id="id16ef84da-eac9-41e6-94d3-d4d4dc3f24ef"><enum>(C)</enum><header>Deadline</header>
<clause id="id6873cc71-7237-4a0d-8472-67c393c5656b"><enum>(i)</enum><header>Initial
plan</header><text>The first plan developed under subparagraph (A) shall be
completed not later than the later of—</text>
<subclause id="ide0d1406a-d559-4eaa-a8d2-7e8eda7ecb61"><enum>(I)</enum><text>September 1, 2008;
or</text>
</subclause><subclause id="id5e7d810a-2c8d-4437-a918-b8d9431d5091"><enum>(II)</enum><text>60 days after the date
of the enactment of the <short-title>Tom Lantos and Henry
J. Hyde United States Global Leadership Against HIV/AIDS, Tuberculosis, and
Malaria Reauthorization Act of 2008</short-title>.</text>
</subclause></clause><clause id="id6edd3913-c055-4d0f-b34e-d578bc9e2be2"><enum>(ii)</enum><header>Subsequent
plans</header><text>Each of the last four plans developed under subparagraph
(A) shall be completed not later than 30 days before each of the fiscal years
2010 through 2013, respectively.</text>
</clause></subparagraph></paragraph><paragraph id="idc4c29683-7cf7-4f1f-822e-ee19759698cf"><enum>(2)</enum><header>Coordination</header><text>In
order to avoid duplication and maximize efficiency, the Inspectors General
described in paragraph (1) shall coordinate their activities with—</text>
<subparagraph id="id85fc0d05-97e8-4ce2-9f87-f5782f51fb1a"><enum>(A)</enum><text>the Government
Accountability Office; and</text>
</subparagraph><subparagraph id="id57214e54-fe1f-413b-a2e8-501165d1b7bd"><enum>(B)</enum><text>the Inspectors General of
the Department of Commerce, the Department of Defense, the Department of Labor,
and the Peace Corps, as appropriate, pursuant to the 2004 Memorandum of
Agreement Coordinating Audit Coverage of Programs and Activities Implementing
the President’s Emergency Plan for AIDS Relief, or any successor
agreement.</text>
</subparagraph></paragraph><paragraph id="id7017e23c-0ecf-4f5f-ae36-3a7f42b850e4"><enum>(3)</enum><header>Funding</header><text>The
Global AIDS Coordinator and the Coordinator of the United States Government
Activities to Combat Malaria Globally shall make available necessary funds not
exceeding $15,000,000 during the 5-year period beginning on October 1, 2008 to
the Inspectors General described in paragraph (1) for the audits, inspections,
and reviews described in that
paragraph.</text>
</paragraph></subsection><after-quoted-block>.</after-quoted-block></quoted-block>
</subsection><subsection id="idEECFB556BBEE4D69B173C69DE4A1C9D1"><enum>(e)</enum><header>Annual study;
message</header><text>Section 101 of such Act, as amended by this section, is
further amended by adding at the end the following:</text>
<quoted-block changed="added" display-inline="no-display-inline" id="idB3A8F18C780B40D2B7B2747CC1442CBF" reported-display-style="italic" style="OLC">
<subsection id="id1F60A0FDBBCE43D28D733359C93CCF50"><enum>(g)</enum><header>Annual study</header>
<paragraph id="id8B677691A8F54B049A02BF953603D0BB"><enum>(1)</enum><header>In
general</header><text>Not later than September 30, 2009, and annually
thereafter through September 30, 2013, the Global AIDS Coordinator shall
complete a study of treatment providers that—</text>
<subparagraph id="idE7D65B367F8246A5BD5309336353ABEC"><enum>(A)</enum><text>represents a range of
countries and service environments;</text>
</subparagraph><subparagraph id="idF748B731F1D54065B60132A70E629188"><enum>(B)</enum><text>estimates the per-patient
cost of antiretroviral HIV/AIDS treatment and the care of people with HIV/AIDS
not receiving antiretroviral treatment, including a comparison of the costs for
equivalent services provided by programs not receiving assistance under this
Act;</text>
</subparagraph><subparagraph id="idE0031800F39C4961848309D0C6E2997A"><enum>(C)</enum><text>estimates per-patient
costs across the program and in specific categories of service providers,
including—</text>
<clause id="id72DDEB718F194CF4A9C9B8ACE2B4D877"><enum>(i)</enum><text>urban and rural
providers;</text>
</clause><clause id="id5EE9F59BBC6C4F96B1BF9F0E466DF5FE"><enum>(ii)</enum><text>country-specific
providers; and</text>
</clause><clause id="idAA46C03B24484223AA64AFD9F1A1C98A"><enum>(iii)</enum><text>other subcategories, as
appropriate.</text>
</clause></subparagraph></paragraph><paragraph id="id5BEC28D1EE514EE88AA9800C253E2F5C"><enum>(2)</enum><header>Publication</header><text>Not
later than 90 days after the completion of each study under paragraph (1), the
Global AIDS Coordinator shall make the results of such study available on a
publicly accessible Web site.</text>
</paragraph></subsection><subsection id="id78597E6D606B4BE6922EBC27B9EDF922"><enum>(h)</enum><header>Message</header><text>The
Global AIDS Coordinator shall develop a message, to be prominently displayed by
each program receiving funds under this Act, that—</text>
<paragraph id="idA5B400DFB7704B3EA2701ED5618C06E8"><enum>(1)</enum><text>demonstrates that the
program is a commitment by citizens of the United States to the global fight
against HIV/AIDS, tuberculosis, and malaria; and</text>
</paragraph><paragraph id="idA072F8AC2ABB4608B087D1CF1D3912F8"><enum>(2)</enum><text>enhances awareness by
program recipients that the program is an effort on behalf of the citizens of
the United
States.</text>
</paragraph></subsection><after-quoted-block>.</after-quoted-block></quoted-block>
</subsection></section><section id="id080f721c-628f-48d0-869d-41a92d37606b"><enum>102.</enum><header>Interagency working
group</header><text display-inline="no-display-inline">Section 1(f)(2) of the
State Department Basic Authorities Act of 1956 (<external-xref legal-doc="usc" parsable-cite="usc/22/2651a">22 U.S.C. 2651a(f)(2)</external-xref>) is
amended—</text>
<paragraph id="id93cc947e-4d39-4841-8176-f26fb5fccec4"><enum>(1)</enum><text>in subparagraph (A), by
inserting <quote>, partner country finance, health, and other relevant
ministries,</quote> after <quote>community based organizations)</quote> each
place it appears;</text>
</paragraph><paragraph id="idbb85d9ec-882e-42b5-b556-1d1417da32d6"><enum>(2)</enum><text>in subparagraph
(B)(ii)—</text>
<subparagraph id="id90bd23cd-366d-4fb9-8a50-96497df3764d"><enum>(A)</enum><text>by striking subclauses
(IV) and (V);</text>
</subparagraph><subparagraph id="id5aeb0c36-af07-44ce-aeac-ee4e042ff829"><enum>(B)</enum><text>by inserting after
subclause (III) the following:</text>
<quoted-block act-name="" changed="added" id="id5e86956f-c3de-47d5-b10c-5580e0595132" reported-display-style="italic" style="OLC">
<subclause id="id89333814-bba5-4783-9f1e-be5c4a115e1b"><enum>(IV)</enum><text>Establishing an
interagency working group on HIV/AIDS headed by the Global AIDS Coordinator and
comprised of representatives from the United States Agency for International
Development and the Department of Health and Human Services, for the purposes
of coordination of activities relating to HIV/AIDS, including—</text>
<item id="idaca62b79-ec0d-4c90-bcdb-dc24e3904591"><enum>(aa)</enum><text>meeting regularly to
review progress in partner countries toward HIV/AIDS prevention, treatment, and
care objectives;</text>
</item><item id="id7a5f4d81-083b-4693-a4c6-cb14a71eead1"><enum>(bb)</enum><text>participating in the
process of identifying countries to consider for increased assistance based on
the epidemiology of HIV/AIDS in those countries, including clear evidence of a
public health threat, as well as government commitment to address the HIV/AIDS
problem, relative need, and coordination and joint planning with other
significant actors;</text>
</item><item id="id41283d65-d392-4dbc-b757-e80aceaabd84"><enum>(cc)</enum><text>assisting the
Coordinator in the evaluation, execution, and oversight of country operational
plans;</text>
</item><item id="id376d994b-82f7-4d10-98ae-4050918b7bc4"><enum>(dd)</enum><text>reviewing policies that
may be obstacles to reaching targets set forth for HIV/AIDS prevention,
treatment, and care; and</text>
</item><item commented="no" display-inline="no-display-inline" id="id21027766-5c69-44d5-bb9e-b8da16239753"><enum>(ee)</enum><text>consulting with
representatives from additional relevant agencies, including the National
Institutes of Health, the Health Resources and Services Administration, the
Department of Labor, the Department of Agriculture, the Millennium Challenge
Corporation, the Peace Corps, and the Department of Defense.</text>
</item></subclause><subclause commented="no" display-inline="no-display-inline" id="id6c411aa4-257b-4746-aa6d-04881e099c31"><enum>(V)</enum><text>Coordinating overall
United States HIV/AIDS policy and programs, including ensuring the coordination
of relevant executive branch agency activities in the field, with efforts led
by partner countries, and with the assistance provided by other relevant
bilateral and multilateral aid agencies and other donor institutions to promote
harmonization with other programs aimed at preventing and treating HIV/AIDS and
other health challenges, improving primary health, addressing food security,
promoting education and development, and strengthening health care
systems.</text>
</subclause><after-quoted-block>;</after-quoted-block></quoted-block>
</subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="id4f2d0a6d-6219-4387-bf48-d2c1126b042d"><enum>(C)</enum><text>by redesignating
subclauses (VII) and VIII) as subclauses (IX) and (XII), respectively;</text>
</subparagraph><subparagraph id="id6186c037-4bef-4a75-9807-161482fb69e3"><enum>(D)</enum><text>by inserting after
subclause (VI) the following:</text>
<quoted-block act-name="" changed="added" id="id1ab31813-66f0-479c-ac5b-9791e8366a21" reported-display-style="italic" style="OLC">
<subclause id="ide48f1a3a-9424-4202-8357-98f3876419e4"><enum>(VII)</enum><text>Holding annual
consultations with nongovernmental organizations in partner countries that
provide services to improve health, and advocating on behalf of the individuals
with HIV/AIDS and those at particular risk of contracting HIV/AIDS, including
organizations with members who are living with HIV/AIDS.</text>
</subclause><subclause id="id297010ed-3325-494f-b6fb-e71c81e627b4"><enum>(VIII)</enum><text>Ensuring, through
interagency and international coordination, that HIV/AIDS programs of the
United States are coordinated with, and complementary to, the delivery of
related global health, food security, development, and
education.</text>
</subclause><after-quoted-block>;</after-quoted-block></quoted-block>
</subparagraph><subparagraph id="idab97968c-7fbb-4e84-add5-0573dc779624"><enum>(E)</enum><text>in subclause (IX), as
redesignated by subparagraph (C)—</text>
<clause id="idaf4cc195-4525-43f6-84f3-dd998a6a640d"><enum>(i)</enum><text>by inserting
<quote>Vietnam,</quote> after <quote>Uganda,</quote>;</text>
</clause><clause id="id71c9b854-a033-40f4-9236-be6e492dd67a"><enum>(ii)</enum><text>by inserting after
<quote>of 2003</quote> the following: ‘‘and other countries in which the United
States is implementing HIV/AIDS programs as part of its foreign assistance
program’’; and</text>
</clause><clause id="idb13c3837-3928-45ac-9c9d-76c0529d1f79"><enum>(iii)</enum><text>by adding at the end
the following: <quote>In designating additional countries under this
subparagraph, the President shall give priority to those countries in which
there is a high prevalence of HIV or risk of significantly increasing incidence
of HIV within the general population and inadequate financial means within the
country.</quote>;</text>
</clause></subparagraph><subparagraph id="id604bebdd-0045-4e31-bc0d-c9bebf781470"><enum>(F)</enum><text>by inserting after
subclause (IX), as redesignated by subparagraph (C), the following:</text>
<quoted-block act-name="" changed="added" id="idf80e34aa-913e-4b2e-8b11-d6e04afc0bbd" reported-display-style="italic" style="OLC">
<subclause id="iddc079f26-f225-49c3-bba6-0289936fae37"><enum>(X)</enum><text>Working with partner
countries in which the HIV/AIDS epidemic is prevalent among injection drug
users to establish, as a national priority, national HIV/AIDS prevention
programs.</text>
</subclause><subclause id="ida7f8b29f-3f8d-4ca7-944c-08cc89b35e06"><enum>(XI)</enum><text>Working with partner
countries in which the HIV/AIDS epidemic is prevalent among individuals
involved in commercial sex acts to establish, as a national priority, national
prevention programs, including education, voluntary testing, and counseling,
and referral systems that link HIV/AIDS programs with programs to eradicate
trafficking in persons and support alternatives to
prostitution.</text>
</subclause><after-quoted-block>;</after-quoted-block></quoted-block>
</subparagraph><subparagraph id="idfa223cab-574e-41f1-94ae-619d8beb73b0"><enum>(G)</enum><text>in subclause (XII), as
redesignated by subparagraph (C), by striking <quote>funds section</quote> and
inserting <quote>funds appropriated for HIV/ AIDS assistance pursuant to the
authorization of appropriations under section 401 of the
<short-title>United States Leadership Against HIV/AIDS,
Tuberculosis, and Malaria Act of 2003</short-title> (<external-xref legal-doc="usc" parsable-cite="usc/22/7671">22 U.S.C. 7671</external-xref>)</quote>;
and</text>
</subparagraph><subparagraph id="id782d7b6f-9cfc-41eb-9701-33d3f1e7f432"><enum>(H)</enum><text>by adding at the end the
following:</text>
<quoted-block act-name="" changed="added" id="idfd57ea5f-b76c-4986-b55e-702a8ffecd57" reported-display-style="italic" style="OLC">
<subclause id="idc886d4e4-ef82-4e4b-871d-63ec1f1bbc42"><enum>(XIII)</enum><text>Publicizing updated
drug pricing data to inform the purchasing decisions of pharmaceutical
procurement
partners.</text>
</subclause><after-quoted-block>.</after-quoted-block></quoted-block>
</subparagraph></paragraph></section><section id="idae1f1586-c6bb-438f-83cb-80299ec27cb1"><enum>103.</enum><header>Sense of
Congress</header><text display-inline="no-display-inline">Section 102 of the
<short-title>United States Leadership Against HIV/AIDS,
Tuberculosis, and Malaria Act of 2003</short-title> (<external-xref legal-doc="usc" parsable-cite="usc/22/7612">22 U.S.C. 7612</external-xref>) is amended
by adding at the end the following:</text>
<quoted-block act-name="" changed="added" id="id7c12f9a7-3e32-498c-877f-4b1d126df1a9" reported-display-style="italic" style="OLC">
<subsection id="id6fafb16d-0bd4-42d4-afce-7454dc8a936b"><enum>(d)</enum><header>Sense of
Congress</header><text>It is the sense of Congress that—</text>
<paragraph id="id56df379c-1597-4e64-96a9-acbb64d0b451"><enum>(1)</enum><text>full-time country level
coordinators, preferably with management experience, should head each HIV/AIDS
country team for United States missions overseeing significant HIV/AIDS
programs;</text>
</paragraph><paragraph id="id0830076d-03f9-4fa5-9cf3-5b9dcd022d82"><enum>(2)</enum><text>foreign service nationals
provide critically important services in the design and implementation of
United States country-level HIV/AIDS programs and their skills and experience
as public health professionals should be recognized within hiring and
compensation practices; and</text>
</paragraph><paragraph id="id0e838b96-d2af-4668-98c5-77ffed2fc9d6"><enum>(3)</enum><text>staffing levels for
United States country-level HIV/AIDS teams should be adequately maintained to
fulfill oversight and other obligations of the
positions.</text>
</paragraph></subsection><after-quoted-block>.</after-quoted-block></quoted-block>
</section><enum>II</enum><header>Support for multilateral
funds, programs, and public-private partnerships</header>
<section id="id8533e19f-1093-416e-ac2d-5660942188f8"><enum>201.</enum><header>Voluntary
contributions to international vaccine funds</header><text display-inline="no-display-inline">Section 302 of the Foreign Assistance Act of
1961 (<external-xref legal-doc="usc" parsable-cite="usc/22/2222">22 U.S.C. 2222</external-xref>) is amended—</text>
<paragraph id="id91419383-93cd-41ba-95c8-65460ba4cae4"><enum>(1)</enum><text display-inline="yes-display-inline">by inserting after subsection (c) the
following:</text>
<quoted-block changed="added" display-inline="no-display-inline" id="ide8873285-a5f0-4033-bad3-43519d4923fa" reported-display-style="italic" style="OLC">
<subsection id="idd4e3e2ca-6c9f-4869-b245-4f276821e3c7"><enum>(d)</enum><header>Tuberculosis vaccine
development programs</header><text>In addition to amounts otherwise available
under this section, there are authorized to be appropriated to the President
such sums as may be necessary for each of the fiscal years 2009 through 2013,
which shall be used for United States contributions to tuberculosis vaccine
development programs, which may include the Aeras Global TB Vaccine
Foundation.</text>
</subsection><after-quoted-block>;</after-quoted-block></quoted-block>
</paragraph><paragraph id="idcb379faf-5ec1-485b-baae-837e7e01ec47"><enum>(2)</enum><text display-inline="yes-display-inline">in subsection (k)—</text>
<subparagraph id="id8B0AA8318C5847D7B35CAD5825A305BF"><enum>(A)</enum><text display-inline="yes-display-inline">by striking <quote>fiscal years 2004
through 2008</quote> and inserting <quote>fiscal years 2009 through
2013</quote>; and</text>
</subparagraph><subparagraph id="id5082BB5C2CCB443F88176CF079D13535"><enum>(B)</enum><text>by striking
<quote>Vaccine Fund</quote> and inserting <quote>GAVI Fund</quote>.</text>
</subparagraph></paragraph><paragraph id="idfba9da6f-c268-48e7-9346-8db57a170d05"><enum>(3)</enum><text>in subsection (l), by
striking <quote>fiscal years 2004 through 2008</quote> and inserting
<quote>fiscal years 2009 through 2013</quote>; and</text>
</paragraph><paragraph commented="no" display-inline="no-display-inline" id="id1ac90bb1-e49c-468f-a0c6-bdca2d499982"><enum>(4)</enum><text>in subsection (m), by
striking <quote>fiscal years 2004 through 2008</quote> and inserting
<quote>fiscal years 2009 through 2013</quote>.</text>
</paragraph></section><section id="ide3c88720-14d3-4edd-b035-b21e7f38df3a"><enum>202.</enum><header>Participation in the
Global Fund to Fight AIDS, Tuberculosis and Malaria</header>
<subsection id="id93e89314-0b45-44c7-8bf4-2e21b217efe0"><enum>(a)</enum><header>Findings; sense of
Congress</header><text display-inline="yes-display-inline">Section 202(a) of
the <short-title>United States Leadership Against
HIV/AIDS, Tuberculosis, and Malaria Act of 2003</short-title> (22 U.S.C.
7622(a)) is amended to read as follows:</text>
<quoted-block act-name="" changed="added" id="id537663c2-5e0b-42dd-9694-2dbcf31578d4" reported-display-style="italic" style="OLC">
<subsection id="id8b0bd651-6505-487c-b38f-d754f637892a"><enum>(a)</enum><header>Findings; Sense of
Congress</header>
<paragraph id="id43d6f70c-7df2-4118-8bf3-cf8b91a13de3"><enum>(1)</enum><header>Findings</header><text>Congress
makes the following findings:</text>
<subparagraph id="id4633903f-6c54-440e-ac7b-65f8762795c9"><enum>(A)</enum><text>The establishment of the
Global Fund in January 2002 is consistent with the general principles for an
international AIDS trust fund first outlined by Congress in the Global AIDS and
Tuberculosis Relief Act of 2000 (<external-xref legal-doc="public-law" parsable-cite="pl/106/264">Public Law 106–264</external-xref>).</text>
</subparagraph><subparagraph id="id5287263d-520e-42c1-8c92-fded7362c0f2"><enum>(B)</enum><text>The Global Fund is an
innovative financing mechanism which—</text>
<clause id="idaacf7509-324c-4626-96b4-cf5ac770c1db"><enum>(i)</enum><text>has made progress in many
areas in combating HIV/AIDS, tuberculosis, and malaria; and</text>
</clause><clause id="idadea26bc-212f-41f4-866e-e81d32b31e14"><enum>(ii)</enum><text>represents the
multilateral component of this Act, extending United States efforts to more
than 130 countries around the world.</text>
</clause></subparagraph><subparagraph id="idbd829641-5a15-4103-8f32-b7888306762e"><enum>(C)</enum><text>The Global Fund and
United States bilateral assistance programs—</text>
<clause id="id61752b11-0f02-43a3-81ec-63dabc3e682c"><enum>(i)</enum><text>are demonstrating
increasingly effective coordination, with each possessing certain comparative
advantages in the fight against HIV/AIDS, tuberculosis, and malaria; and</text>
</clause><clause id="id7a8ed61b-548f-4625-9193-6c4d092bf6cd"><enum>(ii)</enum><text>often work most
effectively in concert with each other.</text>
</clause></subparagraph><subparagraph id="idc9ff13e2-42dc-4041-9e7b-3f2b7c823325"><enum>(D)</enum><text>The United States
Government—</text>
<clause id="id53db076a-1cc7-4f6a-bb0c-6ce623d3121b"><enum>(i)</enum><text>is the largest supporter
of the Global Fund in terms of resources and technical support;</text>
</clause><clause id="idfb9890af-a479-402f-a2ae-98ee69341e05"><enum>(ii)</enum><text>made the founding
contribution to the Global Fund; and</text>
</clause><clause id="id6c0d74fb-d14a-4913-b7b9-76b8ce8b43c6"><enum>(iii)</enum><text>is fully committed to
the success of the Global Fund as a multilateral public-private
partnership.</text>
</clause></subparagraph></paragraph><paragraph commented="no" display-inline="no-display-inline" id="idb1b1e23f-9c5a-450b-9f49-df895bfef3e6"><enum>(2)</enum><header>Sense of
Congress</header><text>It is the sense of Congress that—</text>
<subparagraph id="idba795e62-a592-4cc2-8a01-f8890040fc1d"><enum>(A)</enum><text>transparency and
accountability are crucial to the long-term success and viability of the Global
Fund;</text>
</subparagraph><subparagraph id="idee415476-ec24-4012-9660-04e7d3f18bca"><enum>(B)</enum><text>the Global Fund has made
significant progress toward addressing concerns raised by the Government
Accountability Office by—</text>
<clause id="id02d06500-c554-481c-a19c-9adde2d9c0fb"><enum>(i)</enum><text>improving risk assessment
and risk management capabilities;</text>
</clause><clause id="iddd5ab98e-4538-4e74-a3fc-1f12ddb16192"><enum>(ii)</enum><text>providing clearer
guidance for and oversight of Local Fund Agents; and</text>
</clause><clause id="id1f9decc1-5f89-4334-aee7-22f6138414f6"><enum>(iii)</enum><text>strengthening the
Office of the Inspector General for the Global Fund;</text>
</clause></subparagraph><subparagraph id="ide212c55d-2f46-4180-bed5-e218a3f6d950"><enum>(C)</enum><text>the provision of
sufficient resources and authority to the Office of the Inspector General for
the Global Fund to ensure that office has the staff and independence necessary
to carry out its mandate will be a measure of the commitment of the Global Fund
to transparency and accountability;</text>
</subparagraph><subparagraph id="id00653b5a-88e2-4602-b120-342dfe916924"><enum>(D)</enum><text>regular, publicly
published financial, programmatic, and reporting audits of the Fund, its
grantees, and Local Fund Agents are also important benchmarks of
transparency;</text>
</subparagraph><subparagraph id="idddacb97c-38eb-4e89-bc2f-cbe416a60399"><enum>(E)</enum><text>the Global Fund should
establish and maintain a system to track—</text>
<clause id="id86539a0f-5677-4544-ba2a-4963d54c1aa7"><enum>(i)</enum><text>the amount of funds
disbursed to each subrecipient on the grant’s fiscal cycle; and</text>
</clause><clause id="idd778aae2-6ea3-4ee4-95e1-b3fad6ba1f2c"><enum>(ii)</enum><text>the distribution of
resources, by grant and principal recipient, for prevention, care, treatment,
drug and commodity purchases, and other purposes;</text>
</clause></subparagraph><subparagraph id="id544a6610-f982-4abd-afa7-46256db2473c"><enum>(F)</enum><text>relevant national
authorities in recipient countries should exempt from duties and taxes all
products financed by Global Fund grants and procured by any principal recipient
or subrecipient for the purpose of carrying out such grants;</text>
</subparagraph><subparagraph id="id7ece86e1-b432-4001-b8d7-886cf712a30b"><enum>(G)</enum><text>the Global Fund, UNAIDS,
and the Global AIDS Coordinator should work together to standardize program
indicators wherever possible;</text>
</subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="id73733751-7176-4171-9624-b3d749137166"><enum>(H)</enum><text>for purposes of
evaluating total amounts of funds contributed to the Global Fund under
subsection (d)(4)(A)(i), the timetable for evaluations of contributions from
sources other than the United States should take into account the fiscal
calendars of other major contributors; and</text>
</subparagraph><subparagraph id="idD08B885A90FF432C8ACF24494A9F764E"><enum>(I)</enum><text>the Global Fund should
not support activities involving the <quote>Affordable Medicines
Facility-Malaria</quote> or similar entities pending compelling evidence of
success from pilot programs as evaluated by the Coordinator of United States
Government Activities to Combat Malaria
Globally.</text>
</subparagraph></paragraph></subsection><after-quoted-block>.</after-quoted-block></quoted-block>
</subsection><subsection id="id3DB0AE747A6147A0B2986E687E7467DE"><enum>(b)</enum><header>Statement of
policy</header><text>Section 202(b) of such Act is amended by adding at the end
the following:</text>
<quoted-block changed="added" display-inline="no-display-inline" id="idCA084605CC1F45779611BCC88F7FEF52" reported-display-style="italic" style="OLC">
<paragraph id="idDBF01A5593CB4B398E201C95119FD2CB"><enum>(3)</enum><header>Statement of
policy</header><text>The United States Government regards the imposition by
recipient countries of taxes or tariffs on goods or services provided by the
Global Fund, which are supported through public and private donations,
including the substantial contribution of the American people, as inappropriate
and inconsistent with standards of good governance. The Global AIDS Coordinator
or other representatives of the United States Government shall work with the
Global Fund to dissuade governments from imposing such duties, tariffs, or
taxes.</text>
</paragraph><after-quoted-block>.</after-quoted-block></quoted-block>
</subsection><subsection id="idfea21235-cb12-4c16-a5ce-cf0488682269"><enum>(c)</enum><header>United States financial
participation</header><text>Section 202(d) of such Act (<external-xref legal-doc="usc" parsable-cite="usc/22/7622">22 U.S.C. 7622(d)</external-xref>) is
amended—</text>
<paragraph id="id604d4556-5248-4e2d-ab9c-18a330d4010d"><enum>(1)</enum><text>in paragraph (1)—</text>
<subparagraph id="iddb97f6f8-debc-4985-8614-6467003ab3ad"><enum>(A)</enum><text>by striking
<quote>$1,000,000,000 for the period of fiscal year 2004 beginning on January
1, 2004</quote> and inserting <quote>$2,000,000,000 for fiscal year
2009,</quote>; and</text>
</subparagraph><subparagraph id="id17480891-a185-43b0-8362-75e43a4e8524"><enum>(B)</enum><text>by striking <quote>the
fiscal years 2005–2008</quote> and inserting <quote>each of the fiscal years
2010 through 2013</quote>;</text>
</subparagraph></paragraph><paragraph id="id9e56c2e2-48f8-43ec-ba7d-4321048d969c"><enum>(2)</enum><text>in paragraph (4)—</text>
<subparagraph id="id42348c25-f91c-4dd0-a59b-7c5262580e23"><enum>(A)</enum><text>in subparagraph
(A)—</text>
<clause id="idd034e89a-d826-4968-9296-358a31a3f14a"><enum>(i)</enum><text>in clause (i), by
striking <quote>fiscal years 2004 through 2008</quote> and inserting
<quote>fiscal years 2009 through 2013</quote>;</text>
</clause><clause id="id1e4b4a70-04c8-4924-8988-7bac2b6ceb01"><enum>(ii)</enum><text>in clause (ii)—</text>
<subclause id="id7D03723F35154BCB84E11021BE8A65BF"><enum>(I)</enum><text>by striking <quote>during
any of the fiscal years 2004 through 2008</quote> and inserting <quote>during
any of the fiscal years 2009 through 2013</quote>; and</text>
</subclause><subclause id="idA46FA2545536477BABC1494554647234"><enum>(II)</enum><text>by adding at the end the
following: <quote>The President may waive the application of this clause with
respect to assistance for Sudan that is overseen by the Southern Country
Coordinating Mechanism, including Southern Sudan, Southern Kordofan, Blue Nile
State, and Abyei, if the President determines that the national interest or
humanitarian reasons justify such a waiver. The President shall publish each
waiver of this clause in the Federal Register and, not later than 15 days
before the waiver takes effect, shall consult with the Committee on Foreign
Relations of the Senate and the Committee on Foreign Affairs of the House of
Representatives regarding the proposed waiver.</quote>; and</text>
</subclause></clause><clause id="id398639bc-bc10-4ed8-92ff-26c5eea8950b"><enum>(iii)</enum><text>in clause (vi)—</text>
<subclause id="id9a13faf0-f5a9-4420-afd9-52063e155d8c"><enum>(I)</enum><text>by striking <quote>for
the purposes</quote> and inserting <quote>For the purposes</quote>;</text>
</subclause><subclause id="id89126c84-d794-4967-b7c3-9609fd6d25df"><enum>(II)</enum><text>by striking
<quote>fiscal years 2004 through 2008</quote> and inserting <quote>fiscal years
2009 through 2013</quote>; and</text>
</subclause><subclause id="id1adaeb24-ce7d-4487-a205-0032f1578b55"><enum>(III)</enum><text>by striking
<quote>prior to fiscal year 2004</quote> and inserting <quote>before fiscal
year 2009</quote>;</text>
</subclause></clause></subparagraph><subparagraph id="id2284ccf7-984d-4e54-841e-19c78a53f417"><enum>(B)</enum><text>in subparagraph (B)(iv),
by striking <quote>fiscal years 2004 through 2008</quote> and inserting
<quote>fiscal years 2009 through 2013</quote>; and</text>
</subparagraph><subparagraph id="idab0d13a3-2104-4903-afb2-f9103b454641"><enum>(C)</enum><text>in subparagraph (C)(ii),
by striking <quote>Committee on International Relations</quote> and inserting
<quote>Committee on Foreign Affairs</quote>; and</text>
</subparagraph></paragraph><paragraph id="id7230e2d9-8f54-48b8-8c0f-5d9b6d3e21bc"><enum>(3)</enum><text>by adding at the end the
following:</text>
<quoted-block changed="added" display-inline="no-display-inline" id="id54ec5a2d-2aeb-4187-b048-c25d82a0e40a" reported-display-style="italic" style="OLC">
<paragraph id="id84ad0fd6-59b7-4b1b-91d3-a6a868c3c287"><enum>(5)</enum><header>Withholding
funds</header><text>Notwithstanding any other provision of this Act, 20 percent
of the amounts appropriated pursuant to this Act for a contribution to support
the Global Fund for each of the fiscal years 2010 through 2013 shall be
withheld from obligation to the Global Fund until the Secretary of State
certifies to the appropriate congressional committees that the Global
Fund—</text>
<subparagraph id="id4c78d383-ca3d-485b-8487-8b937f99892b"><enum>(A)</enum><text>has established an
evaluation framework for the performance of Local Fund Agents (referred to in
this paragraph as <quote>LFAs</quote>);</text>
</subparagraph><subparagraph id="idaacfc420-a73f-4c50-9517-067cd7d985f9"><enum>(B)</enum><text>is undertaking a
systematic assessment of the performance of LFAs;</text>
</subparagraph><subparagraph id="ID78e8f622c40d4ac6a58c3edcd73c11b7"><enum>(C)</enum><text>has adopted, and is
implementing, a policy to publish on a publicly available Web site—</text>
<clause id="id38605A5D7281438880273357573A8839"><enum>(i)</enum><text>grant performance
reviews;</text>
</clause><clause id="idA02B231E6EBD413C8554E2241D478192"><enum>(ii)</enum><text>all reports of the
Inspector General of the Global Fund, in a manner that is consistent with the
Policy for Disclosure of Reports of the Inspector General, approved at the 16th
Meeting of the Board of the Global Fund;</text>
</clause><clause id="idAE984BAFA9E3487D98F4F2197E08A7ED"><enum>(iii)</enum><text>decision points of the
Board of the Global Fund;</text>
</clause><clause id="id527CBA876F70459DADA25AF424EC01E3"><enum>(iv)</enum><text>reports from Board
committees to the Board; and</text>
</clause><clause id="id2E5D78ECF80441108A6A6143E3DDF592"><enum>(v)</enum><text>a regular collection and
analysis of performance data and funding of grants of the Global Fund, which
shall cover all principal recipients and all subrecipients;</text>
</clause></subparagraph><subparagraph id="id11004598-0888-435f-9db7-e59be36d9bb8"><enum>(D)</enum><text>is maintaining an
independent, well-staffed Office of the Inspector General that—</text>
<clause id="ide78fdf23-f1bc-4930-bbb8-6eb058064c4f"><enum>(i)</enum><text>reports directly to the
Board of the Global Fund; and</text>
</clause><clause id="ida99a1a1e-e29f-46fb-ac87-6c68bae4448c"><enum>(ii)</enum><text>compiles regular,
publicly published audits of financial, programmatic, and reporting aspects of
the Global Fund, its grantees, and LFAs;</text>
</clause></subparagraph><subparagraph id="id0f35e2fd-7ac2-49be-ab37-bbac202340cc"><enum>(E)</enum><text>has established, and is
reporting publicly on, standard indicators for all program areas;</text>
</subparagraph><subparagraph id="id331ba173-502b-4a5f-a24f-8b872ff3fd2e"><enum>(F)</enum><text>has established a
methodology to track and is publicly reporting on—</text>
<clause id="id56162553-5cbe-4654-976c-c1639c8e549f"><enum>(i)</enum><text>all subrecipients and the
amount of funds disbursed to each subrecipient on the grant’s fiscal cycle;
and</text>
</clause><clause id="idc0e42f55-11ba-47a6-b501-111d5dc08bbe"><enum>(ii)</enum><text>the distribution of
resources, by grant and principal recipient, for prevention, care, treatment,
drugs and commodities purchase, and other purposes;</text>
</clause></subparagraph><subparagraph id="ide7ce6619-5856-4396-bbe1-241b2bfdd95c"><enum>(G)</enum><text>has established a policy
on tariffs imposed by national governments on all goods and services financed
by the Global Fund;</text>
</subparagraph><subparagraph id="id6809b801-3ece-4865-84a3-ad0a30583186"><enum>(H)</enum><text>through its Secretariat,
has taken meaningful steps to prevent national authorities in recipient
countries from imposing taxes or tariffs on goods or services provided by the
Fund;</text>
</subparagraph><subparagraph id="id967e3e07-1022-49fc-a745-cd26c0fb160e"><enum>(I)</enum><text>is maintaining its status
as a financing institution focused on programs directly related to HIV/AIDS,
malaria, and tuberculosis;</text>
</subparagraph><subparagraph id="id4c881192-3212-4dde-b51e-d439bd012843"><enum>(J)</enum><text>is maintaining and making
progress on—</text>
<clause id="idf6972fbc-26e7-48d7-a6fa-d3b7523dee52"><enum>(i)</enum><text>sustaining its
multisectoral approach, through country coordinating mechanisms; and</text>
</clause><clause id="ide2f55a5a-0a19-49ee-a3d2-b6e551429493"><enum>(ii)</enum><text>the implementation of
grants, as reflected in the proportion of resources allocated to different
sectors, including governments, civil society, and faith- and community-based
organizations; and</text>
</clause></subparagraph><subparagraph id="id849ACA2E049F46A687484BC2C0124E38"><enum>(K)</enum><text>has established
procedures providing access by the Office of Inspector General of the
Department of State and Broadcasting Board of Governors, as cognizant Inspector
General, and the Inspector General of the Health and Human Services and the
Inspector General of the United States Agency for International Development, to
Global Fund financial data, and other information relevant to United States
contributions (as determined by the Inspector General in consultation with the
Global AIDS Coordinator).</text>
</subparagraph></paragraph><paragraph commented="no" display-inline="no-display-inline" id="id0EB9577DE7DD4B7F8B57641DB5990662"><enum>(6)</enum><header display-inline="yes-display-inline">Summaries of Board decisions and United
States positions</header><text display-inline="yes-display-inline">Following
each meeting of the Board of the Global Fund, the Coordinator of United States
Government Activities to Combat HIV/AIDS Globally shall report on the public
website of the Coordinator a summary of Board decisions and how the United
States Government voted and its positions on such
decisions.</text>
</paragraph><after-quoted-block>.</after-quoted-block></quoted-block>
</paragraph></subsection></section><section display-inline="no-display-inline" id="HFD0CC8908AF448868CFC472258AB95E5"><enum>203.</enum><header>Research on methods
for women to prevent transmission of HIV and other diseases</header>
<subsection id="H5FA51CFB49AD45D18464FA999F44D1FD"><enum>(a)</enum><header>Sense of
Congress</header><text display-inline="yes-display-inline">Congress recognizes
the need and urgency to expand the range of interventions for preventing the
transmission of human immunodeficiency virus (HIV), including nonvaccine
prevention methods that can be controlled by women.</text>
</subsection><subsection id="H71EC5CD3464B4EC5A8D8F49600DEC5FD"><enum>(b)</enum><header>NIH Office of AIDS
Research</header><text display-inline="yes-display-inline">Subpart 1 of part D
of title XXIII of the Public Health Service Act (<external-xref legal-doc="usc" parsable-cite="usc/42/300cc-40">42 U.S.C. 300cc–40 et seq.</external-xref>) is
amended by inserting after section 2351 the following:</text>
<quoted-block changed="added" display-inline="no-display-inline" id="H86BB20C99E6E447D8CAC07C7B400ECF7" reported-display-style="italic" style="OLC">
<section id="H70AF1217A9554126A56B476B9D922F05"><enum>2351A.</enum><header>Microbicide
research</header>
<subsection id="H7B7EEF2E12D94D3BB3F95E5EBC36DE59"><enum>(a)</enum><header>Federal Strategic
Plan</header><text display-inline="yes-display-inline">The Director of the
Office shall—</text>
<paragraph id="H69D9C94E09E443E6849DBF59DAE5E0C3"><enum>(1)</enum><text display-inline="yes-display-inline">expedite the implementation of the Federal
strategic plans required by section 403(a) of the Public Health Service Act (42
U.S.C. 283(a)(5)) regarding the conduct and support of research on, and
development of, a microbicide to prevent the transmission of the human
immunodeficiency virus; and</text>
</paragraph><paragraph id="HDB275AD1B44E4CF0A60398562ED53E3"><enum>(2)</enum><text display-inline="yes-display-inline">review and, as appropriate, revise such
plan to prioritize funding and activities relative to their scientific urgency
and potential market readiness.</text>
</paragraph></subsection><subsection id="H62CD4D3A11C24936B1AEDE419C90094"><enum>(b)</enum><header>Coordination</header><text>In
implementing, reviewing, and prioritizing elements of the plan described in
subsection (a), the Director of the Office shall consult, as appropriate,
with—</text>
<paragraph id="H8E40C11F31F84A3084E5848225E98D04"><enum>(1)</enum><text display-inline="yes-display-inline">representatives of other Federal agencies
involved in microbicide research, including the Coordinator of United States
Government Activities to Combat HIV/AIDS Globally, the Director of the Centers
for Disease Control and Prevention, and the Administrator of the United States
Agency for International Development;</text>
</paragraph><paragraph id="H7E8DC4B3305B4C0CBE98FFA7FB22B93"><enum>(2)</enum><text>the microbicide research
and development community; and</text>
</paragraph><paragraph id="HFB90EAE88B6E4DBD8E2D2C713DFAA89B"><enum>(3)</enum><text>health
advocates.</text>
</paragraph></subsection></section><after-quoted-block>.</after-quoted-block></quoted-block>
</subsection><subsection id="HDA64A4F4287A49D499A934235750BA1B"><enum>(c)</enum><header>National institute of
allergy and infectious diseases</header><text>Subpart 6 of part C of title IV
of the Public Health Service Act (<external-xref legal-doc="usc" parsable-cite="usc/42/285f">42 U.S.C. 285f et seq.</external-xref>) is amended by adding
at the end the following:</text>
<quoted-block changed="added" display-inline="no-display-inline" id="HCBD8BC0C68F24A37923646003B00DAEF" reported-display-style="italic" style="OLC">
<section id="H6D8F79FAE9674DE40000E6BD862E2631"><enum>447C.</enum><header>Microbicide research
and development</header><text display-inline="no-display-inline">The Director
of the Institute, acting through the head of the Division of AIDS, shall,
consistent with the peer-review process of the National Institutes of Health,
carry out research on, and development of, safe and effective methods for use
by women to prevent the transmission of the human immunodeficiency virus, which
may include
microbicides.</text>
</section><after-quoted-block>.</after-quoted-block></quoted-block>
</subsection><subsection id="HFF6A25DE2E914B83BF86BE15A62E8982"><enum>(d)</enum><header>CDC</header><text>Part
B of title III of the Public Health Service Act (<external-xref legal-doc="usc" parsable-cite="usc/42/243">42 U.S.C. 243 et seq.</external-xref>) is
amended by inserting after section 317S the following:</text>
<quoted-block changed="added" display-inline="no-display-inline" id="H38B8F36BA9BF4551AE45EA71CE913D11" reported-display-style="italic" style="OLC">
<section id="H489642D154FB4899BD1D793D117E4697"><enum>317T.</enum><header>Microbicide
research</header>
<subsection id="HE48FF1D2F9574791990049F6028E94FC"><enum>(a)</enum><header>In
general</header><text>The Director of the Centers for Disease Control and
Prevention is strongly encouraged to fully implement the Centers’ microbicide
agenda to support research and development of microbicides for use to prevent
the transmission of the human immunodeficiency virus.</text>
</subsection><subsection id="HFEC940A21FC34F52830036DE84A24C89"><enum>(b)</enum><header>Authorization of
appropriations</header><text>There are authorized to be appropriated such sums
as may be necessary for each of fiscal years 2009 through 2013 to carry out
this
section.</text>
</subsection></section><after-quoted-block>.</after-quoted-block></quoted-block>
</subsection><subsection id="HB78191D97E984A00B6A858B12B3158BC"><enum>(e)</enum><header>United States Agency
for International Development</header>
<paragraph id="HC3A0DD99FBE645DEB800DF103BF51222"><enum>(1)</enum><header>In
general</header><text display-inline="yes-display-inline">The Administrator of
the United States Agency for International Development, in coordination with
the Coordinator of United States Government Activities to Combat HIV/AIDS
Globally, may facilitate availability and accessibility of microbicides,
provided that such pharmaceuticals are approved, tentatively approved, or
otherwise authorized for use by—</text>
<subparagraph id="id5599D9C3D2BF4465AA10AD1D1DE44559"><enum>(A)</enum><text>the Food and Drug
Administration;</text>
</subparagraph><subparagraph id="id055B6BA9A3CD43B6897CF07B5FDBDCCB"><enum>(B)</enum><text>a stringent regulatory
agency acceptable to the Secretary of Health and Human Services; or</text>
</subparagraph><subparagraph id="ID317d75e8661d438eb399ededb7401ca0"><enum>(C)</enum><text>a quality assurance
mechanism acceptable to the Secretary of Health and Human Services.</text>
</subparagraph></paragraph><paragraph commented="no" display-inline="no-display-inline" id="HE476A4C26CFB410783805549BD07F67D"><enum>(2)</enum><header>Authorization of
appropriations</header><text>Of the amounts authorized to be appropriated under
section 401 of the United States Leadership Against HIV/AIDS, Tuberculosis, and
Malaria Act of 2003 (<external-xref legal-doc="usc" parsable-cite="usc/22/7671">22 U.S.C. 7671</external-xref>) for HIV/AIDS assistance, there are
authorized to be appropriated to the President such sums as may be necessary
for each of the fiscal years 2009 through 2013 to carry out this
subsection.</text>
</paragraph></subsection></section><section id="id665907a5-869b-42b1-adc7-3b6426613de1"><enum>204.</enum><header>Combating HIV/AIDS,
tuberculosis, and malaria by strengthening health policies and health systems
of partner countries</header>
<subsection id="ida11cb2db-8812-4640-8149-b8b32c4df324"><enum>(a)</enum><header>In
general</header><text>Title II of the <short-title>United
States Leadership Against HIV/AIDS, Tuberculosis, and Malaria Act of
2003</short-title> (<external-xref legal-doc="usc" parsable-cite="usc/22/7621">22 U.S.C. 7621</external-xref>) is amended by adding at the end the
following:</text>
<quoted-block changed="added" display-inline="no-display-inline" id="id3b5fd2c4-0c6c-4e47-b43c-b94428245d00" reported-display-style="italic" style="OLC">
<section id="idb14294b2-8b79-48a3-a30f-abcae47a3850"><enum>204.</enum><header>Combating HIV/AIDS,
tuberculosis, and malaria by strengthening health policies and health systems
of partner countries</header>
<subsection id="ided05cd33-f515-40a2-8b6b-0bb20c22da06"><enum>(a)</enum><header>Statement of
policy</header><text>It shall be the policy of the United States
Government—</text>
<paragraph id="id7b27e375-a02a-4159-ba88-800e747599fe"><enum>(1)</enum><text>to invest appropriate
resources authorized under this Act—</text>
<subparagraph id="id9e710e22-c769-4815-b872-f773604aa170"><enum>(A)</enum><text>to carry out activities
to strengthen HIV/AIDS, tuberculosis, and malaria health policies and health
systems; and</text>
</subparagraph><subparagraph id="ide7ec564d-e3df-4c08-b97e-396e0b4cf1b4"><enum>(B)</enum><text>to provide workforce
training and capacity-building consistent with the goals and objectives of this
Act; and</text>
</subparagraph></paragraph><paragraph id="idae0a5bec-23de-48d3-86a7-75fd1c9ab80d"><enum>(2)</enum><text>to support the
development of a sound policy environment in partner countries to increase the
ability of such countries—</text>
<subparagraph id="ida5790523-9c3e-461b-b923-eb3ee6129b8d"><enum>(A)</enum><text>to maximize utilization
of health care resources from donor countries;</text>
</subparagraph><subparagraph id="idb3096139-3e78-4438-b6e5-78a6c507f316"><enum>(B)</enum><text>to increase national
investments in health and education and maximize the effectiveness of such
investments;</text>
</subparagraph><subparagraph id="id00d9d1c6-ba97-47e8-a7ba-3ccd21fb51c3"><enum>(C)</enum><text>to improve national
HIV/AIDS, tuberculosis, and malaria strategies;</text>
</subparagraph><subparagraph id="id6bd43415-2f5e-468c-9d3b-4e4ae88abb5d"><enum>(D)</enum><text>to deliver evidence-based
services in an effective and efficient manner; and</text>
</subparagraph><subparagraph id="id184a9e69-6b97-4c9b-9f0e-2fde4f74670a"><enum>(E)</enum><text>to reduce barriers that
prevent recipients of services from achieving maximum benefit from such
services.</text>
</subparagraph></paragraph></subsection><subsection id="id6df407f9-0a6c-45f1-b445-0fd0584431c5"><enum>(b)</enum><header>Assistance To improve
public finance management systems</header>
<paragraph id="id8f9f8772-c73b-460e-9d58-ac52fc599ee2"><enum>(1)</enum><header>In
general</header><text>Consistent with the authority under section 129 of the
Foreign Assistance Act of 1961 (<external-xref legal-doc="usc" parsable-cite="usc/22/2152">22 U.S.C. 2152</external-xref>), the Secretary of the Treasury,
acting through the head of the Office of Technical Assistance, is authorized to
provide assistance for advisors and partner country finance, health, and other
relevant ministries to improve the effectiveness of public finance management
systems in partner countries to enable such countries to receive funding to
carry out programs to combat HIV/AIDS, tuberculosis, and malaria and to manage
such programs.</text>
</paragraph><paragraph id="idb28c135c-bc19-40c4-aabe-0e6f4c8d8832"><enum>(2)</enum><header>Authorization of
appropriations</header><text>Of the amounts authorized to be appropriated under
section 401 for HIV/AIDS assistance, there are authorized to be appropriated to
the Secretary of the Treasury such sums as may be necessary for each of the
fiscal years 2009 through 2013 to carry out this subsection.</text>
</paragraph></subsection><subsection id="ID9785e18f67204e64affa568d4d635c3b"><enum>(c)</enum><header>Plan
required</header><text>The Global AIDS Coordinator, in collaboration with the
Administrator of the United States Agency for International Development
(USAID), shall develop and implement a plan to combat HIV/AIDS by strengthening
health policies and health systems of partner countries as part of USAID’s
<quote>Health Systems 2020</quote> project. Recognizing that human and
institutional capacity form the core of any health care system that can sustain
the fight against HIV/AIDS, tuberculosis, and malaria, the plan shall include a
strategy to encourage postsecondary educational institutions in partner
countries, particularly in Africa, in collaboration with United States
postsecondary educational institutions, including historically black colleges
and universities, to develop such human and institutional capacity and in the
process further build their capacity to sustain the fight against these
diseases.</text>
</subsection></section><after-quoted-block>.</after-quoted-block></quoted-block>
</subsection><subsection id="id4f69c6f3-9266-40a8-b896-61a44a42cd49"><enum>(b)</enum><header>Clerical
amendment</header><text>The table of contents for the
<short-title>United States Leadership Against HIV/AIDS,
Tuberculosis, and Malaria Act of 2003</short-title> (<external-xref legal-doc="usc" parsable-cite="usc/22/7601">22 U.S.C. 7601</external-xref> note) is
amended by inserting after the item relating to section 203, as added by
section 203 of this Act, the following:</text>
<quoted-block changed="added" id="id2b1db2a1-346a-4498-8340-21ed157546b0" reported-display-style="italic" style="OLC">
<toc changed="added" reported-display-style="italic">
<toc-entry level="section">Sec. 204. Combating HIV/AIDS, tuberculosis, and
malaria by strengthening health policies and health systems of partner
countries.</toc-entry>
</toc>
<after-quoted-block>.</after-quoted-block></quoted-block>
</subsection></section><section id="idff648a8a-d64f-4a3f-a7db-3ca2f4842744"><enum>205.</enum><header>Facilitating effective
operations of the Centers for Disease Control</header><text display-inline="no-display-inline">Section 307 of the Public Health Service Act
(<external-xref legal-doc="usc" parsable-cite="usc/42/242l">42 U.S.C. 242l</external-xref>) is amended—</text>
<paragraph id="id31b9248d-60f5-4579-bd8c-cfd9f5b9b834"><enum>(1)</enum><text>by amending subsection
(a) to read as follows:</text>
<quoted-block changed="added" display-inline="no-display-inline" id="ida5a0b3cd-6c38-4026-93f5-6a0a20bd48e9" reported-display-style="italic" style="OLC">
<subsection id="id4a587a6d-2f37-4ebe-987b-1fb04b2bce74"><enum>(a)</enum><text>The Secretary may
participate with other countries in cooperative endeavors in—</text>
<paragraph id="idc8ec7f9c-dd41-4b95-98b9-b26983041b97"><enum>(1)</enum><text>biomedical research,
health care technology, and the health services research and statistical
analysis authorized under section 306 and title IX; and</text>
</paragraph><paragraph id="idd5ab5660-1f3c-4108-83a3-2c67121a9fe9"><enum>(2)</enum><text>biomedical research,
health care services, health care research, or other related activities in
furtherance of the activities, objectives or goals authorized under the
<short-title>Tom Lantos and Henry J. Hyde United States
Global Leadership Against HIV/AIDS, Tuberculosis, and Malaria Reauthorization
Act of 2008</short-title>.</text>
</paragraph></subsection><after-quoted-block>;
and</after-quoted-block></quoted-block>
</paragraph><paragraph id="id79a125a2-cdd8-4757-9887-413ea40df4cf"><enum>(2)</enum><text>in subsection (b)—</text>
<subparagraph id="ide6641d63-6825-4355-b9b7-9077dd3c591e"><enum>(A)</enum><text>in paragraph (7), by
striking <quote>and</quote> after the semicolon at the end;</text>
</subparagraph><subparagraph id="id874f5454-af94-461c-bfda-690195b9175d"><enum>(B)</enum><text>by striking <quote>The
Secretary may not, in the exercise of his authority under this section, provide
financial assistance for the construction of any facility in any foreign
country.</quote></text>
</subparagraph><subparagraph id="id82a980c4-9213-4dc6-b924-b2191fc0d1f0"><enum>(C)</enum><text>in paragraph (8), by
striking <quote>for any purpose.</quote> and inserting <quote>for the purpose
of any law administered by the Office of Personnel Management;</quote>;
and</text>
</subparagraph><subparagraph id="id8846629e-c4ea-4884-af23-43cc9c472e97"><enum>(D)</enum><text>by adding at the end the
following:</text>
<quoted-block changed="added" display-inline="no-display-inline" id="id31169706-98b8-48c8-a38d-f3f358117516" reported-display-style="italic" style="OLC">
<paragraph id="id0f865a79-1600-4bcd-a0bf-aeae78f3f7d8"><enum>(9)</enum><text>provide such funds by
advance or reimbursement to the Secretary of State, as may be necessary, to pay
the costs of acquisition, lease, construction, alteration, equipping,
furnishing or management of facilities outside of the United States; and</text>
</paragraph><paragraph id="id2472ab26-d552-4bd7-a958-beda816d8ab1"><enum>(10)</enum><text>in consultation with the
Secretary of State, through grant or cooperative agreement, make funds
available to public or nonprofit private institutions or agencies in foreign
countries in which the Secretary is participating in activities described under
subsection (a) to acquire, lease, construct, alter, or renovate facilities in
those
countries.</text>
</paragraph><after-quoted-block>.</after-quoted-block></quoted-block>
</subparagraph></paragraph><paragraph id="id5cb0cbcf-3daf-468d-b159-225e74310667"><enum>(3)</enum><text>in subsection (c)—</text>
<subparagraph id="id61aeef51-ea40-427f-8d12-3b2bb2a3b79b"><enum>(A)</enum><text>by striking
<quote>1990</quote> and inserting <quote>1980</quote>; and</text>
</subparagraph><subparagraph id="id3816ac9c-987d-4b2b-997e-4ebfb1d02b84"><enum>(B)</enum><text>by inserting or <quote>or
section 903 of the Foreign Service Act of 1980 (<external-xref legal-doc="usc" parsable-cite="usc/22/4083">22 U.S.C. 4083</external-xref>)</quote> after
<quote>Code</quote>.</text>
</subparagraph></paragraph></section><section id="idAEB588E8AEE544C69A4C86EB57FF6231"><enum>206.</enum><header>Facilitating vaccine
development</header>
<subsection id="id3A0DE7F35C2D436F981476734ABE0BCC"><enum>(a)</enum><header>Technical assistance
for developing countries</header><text>The Administrator of the United States
Agency for International Development, utilizing public-private partners, as
appropriate, and working in coordination with other international development
agencies, is authorized to strengthen the capacity of developing countries’
governmental institutions to—</text>
<paragraph id="idBE282F83172245CDA81BBE3017E79CC6"><enum>(1)</enum><text>collect evidence for
informed decision-making and introduction of new vaccines, including potential
HIV/AIDS, tuberculosis, and malaria vaccines, if such vaccines are determined
to be safe and effective;</text>
</paragraph><paragraph id="id7286464C873B42749854C21F2E170452"><enum>(2)</enum><text>review protocols for
clinical trials and impact studies and improve the implementation of clinical
trials; and</text>
</paragraph><paragraph id="idEF04388E17B342CE987882875CF3DE46"><enum>(3)</enum><text>ensure adequate supply
chain and delivery systems.</text>
</paragraph></subsection><subsection id="IDdc7f2d1d42f741af9e2bac981900da49"><enum>(b)</enum><header>Advanced market
commitments</header>
<paragraph id="ID84d99450d1dc404b8ca31b1096bc4ece"><enum>(1)</enum><header>Purpose</header><text>The
purpose of this subsection is to improve global health by requiring the United
States to participate in negotiations for advance market commitments for the
development of future vaccines, including potential vaccines for HIV/AIDS,
tuberculosis, and malaria.</text>
</paragraph><paragraph id="ID53aed9f096304e308620e8cdb5e24b5b"><enum>(2)</enum><header>Negotiation
requirement</header><text>The Secretary of the Treasury shall enter into
negotiations with the appropriate officials of the International Bank of
Reconstruction and Development (World Bank) and the GAVI Alliance, the member
nations of such entities, and other interested parties to establish advanced
market commitments to purchase vaccines to combat HIV/AIDS, tuberculosis,
malaria, and other related infectious diseases.</text>
</paragraph><paragraph id="IDde60198e9dcc409a942de6e8befd5ef4"><enum>(3)</enum><header>Requirements</header><text>In
negotiating the United States participation in programs for advanced market
commitments, the Secretary of the Treasury shall take into account whether
programs for advance market commitments include—</text>
<subparagraph id="IDc995ab7714454853a24d688a717ee29e"><enum>(A)</enum><text>legally binding contracts
for product purchase that include a fair market price for up to a maximum
number of treatments, creating a strong market incentive;</text>
</subparagraph><subparagraph id="IDaffb2bdb0a1a49d7a1594ad0e9909eaf"><enum>(B)</enum><text>clearly defined and
transparent rules of program participation for qualified developers and
suppliers of the product;</text>
</subparagraph><subparagraph id="IDdc87d771b91e4a38a35faea0dd4bf817"><enum>(C)</enum><text>clearly defined
requirements for eligible vaccines to ensure that they are safe and effective
and can be delivered in developing country contexts;</text>
</subparagraph><subparagraph id="ID837fc4bfdd8b4b05a529e91802af3de0"><enum>(D)</enum><text>dispute settlement
mechanisms; and</text>
</subparagraph><subparagraph id="ID1cc28c7736164e149e97550b3840fbb5"><enum>(E)</enum><text>sufficient flexibility to
enable the contracts to be adjusted in accord with new information related to
projected market size and other factors while still maintaining the purchase
commitment at a fair price.</text>
</subparagraph></paragraph><paragraph id="ID42ad34a6b1a74bd3a36eb8679a5357f1"><enum>(4)</enum><header>Report</header><text>Not
later than 1 year after the date of the enactment of this Act—</text>
<subparagraph id="id7885969C0D9F4A98923F68EC32FD16DD"><enum>(A)</enum><text>the Secretary of the
Treasury shall submit a report to the appropriate congressional committees on
the status of the United States negotiations to participate in programs for the
advanced market commitments under this subsection; and</text>
</subparagraph><subparagraph id="idD7807B935B194100B5C1DC1B7ACF6AC1"><enum>(B)</enum><text>the President shall
produce a comprehensive report, written by a study group of qualified
professionals from relevant Federal agencies and initiatives, nongovernmental
organizations, and industry representatives, that sets forth a coordinated
strategy to accelerate development of vaccines for infectious diseases, such as
HIV/AIDS, malaria, and tuberculosis, which includes—</text>
<clause id="id9A03E533DB7B4792A3893C8256E4915A"><enum>(i)</enum><text>initiatives to create
economic incentives for the research, development, and manufacturing of
vaccines for HIV/AIDS, tuberculosis, malaria, and other infectious
diseases;</text>
</clause><clause id="idDCB533FB6DA244079B617B6572AAB232"><enum>(ii)</enum><text>an expansion of
public-private partnerships and the leveraging of resources from other
countries and the private sector; and</text>
</clause><clause id="idF4FFEC18628B4A2CBC7F404CCA5CE9BB"><enum>(iii)</enum><text>efforts to maximize
United States capabilities to support clinical trials of vaccines in developing
countries and to address the challenges of delivering vaccines in developing
countries to minimize delays in access once vaccines are available.</text>
</clause></subparagraph></paragraph></subsection></section><enum>III</enum><header>Bilateral
Efforts</header>
<subtitle id="ide29b343b-6f07-4acf-857f-76aa7460f718"><enum>A</enum><header>General Assistance and
Programs</header>
<section id="id0249c3a5-d95b-4bfc-833a-646b3a98db6b"><enum>301.</enum><header>Assistance to combat
HIV/AIDS</header>
<subsection id="id01b95e0f-f7b3-40aa-8ae0-12f25e1a10b5"><enum>(a)</enum><header>Amendments to the
Foreign Assistance Act of 1961</header>
<paragraph id="id61e7f831-fd47-4d2c-97a7-b4217748f853"><enum>(1)</enum><header>Finding</header><text>Section
104A(a) of the Foreign Assistance Act of 1961 (<external-xref legal-doc="usc" parsable-cite="usc/22/2151b-2">22 U.S.C. 2151b–2(a)</external-xref>) is amended
by inserting <quote>Central Asia, Eastern Europe, Latin America</quote> after
<quote>Caribbean,</quote>.</text>
</paragraph><paragraph id="ide2b1485a-710b-431d-b823-ceaad78ab2ea"><enum>(2)</enum><header>Policy</header><text>Section
104A(b) of such Act is amended to read as follows:</text>
<quoted-block changed="added" display-inline="no-display-inline" id="ida094cdd1-ad76-4bb1-95c0-6e4244df312c" reported-display-style="italic" style="OLC">
<subsection id="id0beb4b19-84e1-431f-b537-cebb90e7a9b9"><enum>(b)</enum><header>Policy</header>
<paragraph id="id4d89b296-d881-4c1e-ab29-a52badd85ec9"><enum>(1)</enum><header>Objectives</header><text>It
is a major objective of the foreign assistance program of the United States to
provide assistance for the prevention and treatment of HIV/AIDS and the care of
those affected by the disease. It is the policy objective of the United States,
by 2013, to—</text>
<subparagraph id="id4f37b4ab-8449-445e-a5e7-f4d19b5f74fa"><enum>(A)</enum><text>assist partner countries
to—</text>
<clause id="idab9d24bd-da33-47b4-954f-8473ae564426"><enum>(i)</enum><text>prevent 12,000,000 new
HIV infections worldwide;</text>
</clause><clause id="id29CB50BF69AF4E2FA3E9B05C716A5F9F"><enum>(ii)</enum><text>support—</text>
<subclause id="idE380D8948BE74AA1B30837FCC314B4D4"><enum>(I)</enum><text>the increase in the
number of individuals with HIV/AIDS receiving antiretroviral treatment above
the goal established under section 402(a)(3) and increased pursuant to
paragraphs (1) through (3) of section 403(d); and</text>
</subclause><subclause id="id54A5207657E34676B11426BC7A83DC18"><enum>(II)</enum><text>additional treatment
through coordinated multilateral efforts;</text>
</subclause></clause><clause id="id36343d6e-b7f0-481b-b1e3-76a2f2b72dda"><enum>(iii)</enum><text>support care for
12,000,000 individuals infected with or affected by HIV/AIDS, including
5,000,000 orphans and vulnerable children affected by HIV/AIDS, with an
emphasis on promoting a comprehensive, coordinated system of services to be
integrated throughout the continuum of care;</text>
</clause><clause id="id68db968e-ace8-4a11-a8b8-4476cc8ba28c"><enum>(iv)</enum><text>provide at least 80
percent of the target population with access to counseling, testing, and
treatment to prevent the transmission of HIV from mother-to-child;</text>
</clause><clause id="id61e4bee3-7727-4b4b-ae32-6e389db91207"><enum>(v)</enum><text>provide care and
treatment services to children with HIV in proportion to their percentage
within the HIV-infected population of a given partner country; and</text>
</clause><clause id="idf36b75ae-02ae-458b-afa0-b66bf654d917"><enum>(vi)</enum><text>train and support
retention of health care professionals, paraprofessionals, and community health
workers in HIV/AIDS prevention, treatment, and care, with the target of
providing such training to at least 140,000 new health care professionals and
paraprofessionals with an emphasis on training and in country deployment of
critically needed doctors and nurses;</text>
</clause></subparagraph><subparagraph id="idf6f6be14-b95c-48dd-80ed-b3c5fbec61f0"><enum>(B)</enum><text>strengthen the capacity
to deliver primary health care in developing countries, especially in
sub-Saharan Africa;</text>
</subparagraph><subparagraph id="ide52deb21-f319-4241-adf6-2a0fc0fa0b69"><enum>(C)</enum><text>support and help
countries in their efforts to achieve staffing levels of at least 2.3 doctors,
nurses, and midwives per 1,000 population, as called for by the World Health
Organization; and</text>
</subparagraph><subparagraph id="idF6BA649990204A5B9715B1765AB4C3AA"><enum>(D)</enum><text>help partner countries to
develop independent, sustainable HIV/AIDS programs.</text>
</subparagraph></paragraph><paragraph id="idb0335fe2-821f-441f-ab4c-2a639e3b49b9"><enum>(2)</enum><header>Coordinated global
strategy</header><text>The United States and other countries with the
sufficient capacity should provide assistance to countries in sub-Saharan
Africa, the Caribbean, Central Asia, Eastern Europe, and Latin America, and
other countries and regions confronting HIV/AIDS epidemics in a coordinated
global strategy to help address generalized and concentrated epidemics through
HIV/AIDS prevention, treatment, care, monitoring and evaluation, and related
activities.</text>
</paragraph><paragraph id="idfa304336-ccd2-48cb-a63f-2e4157b62a01"><enum>(3)</enum><header>Priorities</header><text>The
United States Government’s response to the global HIV/AIDS pandemic and the
Government’s efforts to help countries assume leadership of sustainable
campaigns to combat their local epidemics should place high priority on—</text>
<subparagraph id="idd7678156-68b6-4f86-b900-efa83568a979"><enum>(A)</enum><text>the prevention of the
transmission of HIV;</text>
</subparagraph><subparagraph id="id7338de91-36e0-480b-9e37-f01cbe08230b"><enum>(B)</enum><text>moving toward universal
access to HIV/AIDS prevention counseling and services;</text>
</subparagraph><subparagraph id="id9EB602A406AC4E1E81C6A2B89E67A389"><enum>(C)</enum><text>the inclusion of cost
sharing assurances that meet the requirements under section 110; and</text>
</subparagraph><subparagraph id="id746E211D55C14F35B2D94D23DEA17A22"><enum>(D)</enum><text>the inclusion of
transition strategies to ensure sustainability of such programs and activities,
including health care systems, under other international donor support, or
budget support by respective foreign
governments.</text>
</subparagraph></paragraph></subsection><after-quoted-block>.</after-quoted-block></quoted-block>
</paragraph></subsection><subsection id="id4947b546-e833-45e8-bcb8-e751eee21495"><enum>(b)</enum><header>Authorization</header><text>Section
104A(c) of such Act is amended—</text>
<paragraph id="id40b8b74e-623d-44fa-9398-f303e3aaed33"><enum>(1)</enum><text>in paragraph (1), by
striking <quote>and other countries and areas.</quote> and inserting
<quote>Central Asia, Eastern Europe, Latin America, and other countries and
areas, particularly with respect to refugee populations or those in
postconflict settings in such countries and areas with significant or
increasing HIV incidence rates.</quote>;</text>
</paragraph><paragraph id="idd4ebd769-d822-4b18-a198-a3b3384b7b03"><enum>(2)</enum><text>in paragraph (2), by
striking <quote>and other countries and areas affected by the HIV/AIDS
pandemic</quote> and inserting <quote>Central Asia, Eastern Europe, Latin
America, and other countries and areas affected by the HIV/AIDS pandemic,
particularly with respect to refugee populations or those in post-conflict
settings in such countries and areas with significant or increasing HIV
incidence rates.</quote>; and</text>
</paragraph><paragraph id="id693cfa2c-3158-4a43-bc9e-a2127f6ff36e"><enum>(3)</enum><text>in paragraph (3)—</text>
<subparagraph id="idf5369cf3-b59d-4bdd-8a6a-ff60acd52b12"><enum>(A)</enum><text>by striking
<quote>foreign countries</quote> and inserting <quote>partner countries, other
international actors,</quote>; and</text>
</subparagraph><subparagraph id="id90c33e7b-d89c-4fcb-b51b-341c0f628ee4"><enum>(B)</enum><text>by inserting
<quote>within the framework of the principles of the Three Ones</quote> before
the period at the end.</text>
</subparagraph></paragraph></subsection><subsection id="id774b9a17-edc9-4be6-9bde-2c75dba72315"><enum>(c)</enum><header>Activities
supported</header><text>Section 104A(d) of such Act is amended—</text>
<paragraph id="idf80f3355-0641-43bd-81cd-41d40206b223"><enum>(1)</enum><text>in paragraph (1)—</text>
<subparagraph id="idcdca7390-abfa-420f-a1dd-640f5e071caf"><enum>(A)</enum><text>in subparagraph
(A)—</text>
<clause id="idd829a353-3622-4b02-a71b-48938ae476c8"><enum>(i)</enum><text>by inserting <quote>and
multiple concurrent sexual partnering,</quote> after <quote>casual sexual
partnering</quote>; and</text>
</clause><clause id="id31e75cb9-5a10-44df-8342-ab148a830771"><enum>(ii)</enum><text>by striking
<quote>condoms</quote> and inserting <quote>male and female
condoms</quote>;</text>
</clause></subparagraph><subparagraph id="id225262d5-cc92-4086-82e7-7668bae85179"><enum>(B)</enum><text>in subparagraph
(B)—</text>
<clause id="ida048d9da-53ff-4525-a647-a89f659ee38a"><enum>(i)</enum><text>by striking
<quote>programs that</quote> and inserting <quote>programs that are designed
with local input and</quote>; and</text>
</clause><clause id="idbc543238-044c-49cf-b975-00fbcc4f80f6"><enum>(ii)</enum><text>by striking <quote>those
organizations</quote> and inserting <quote>those locally based
organizations</quote>;</text>
</clause></subparagraph><subparagraph id="idbedf9ab7-0a28-4982-ae0c-b38b3625dffc"><enum>(C)</enum><text>in subparagraph (D), by
inserting <quote>and promoting the use of provider-initiated or
<quote>opt-out</quote> voluntary testing in accordance with World Health
Organization guidelines</quote> before the semicolon at the end;</text>
</subparagraph><subparagraph id="id617efa97-77de-403a-b794-f6af28fe0a48"><enum>(D)</enum><text>by redesignating
subparagraphs (F), (G), and (H) as subparagraphs (H), (I), and (J),
respectively;</text>
</subparagraph><subparagraph id="id915f7732-0d2c-436d-af7c-dedb9730431b"><enum>(E)</enum><text>by inserting after
subparagraph (E) the following:</text>
<quoted-block changed="added" display-inline="no-display-inline" id="id07c8a172-6bb4-4e3d-a955-58134775b3f3" reported-display-style="italic" style="OLC">
<subparagraph id="id0607d82f-73e1-4994-8034-2a821ab64fc2"><enum>(F)</enum><text>assistance to—</text>
<clause id="id67b21502-474a-4fcf-bfea-37f82b812176"><enum>(i)</enum><text>achieve the goal of
reaching 80 percent of pregnant women for prevention and treatment of
mother-to-child transmission of HIV in countries in which the United States is
implementing HIV/AIDS programs by 2013; and</text>
</clause><clause id="id6785a1ca-85fa-46bb-9283-8b78981d058f"><enum>(ii)</enum><text>promote infant feeding
options and treatment protocols that meet the most recent criteria established
by the World Health Organization;</text>
</clause></subparagraph><subparagraph id="id21bd6962-6821-4675-a9de-207f26ced222"><enum>(G)</enum><text>medical male circumcision
programs as part of national strategies to combat the transmission of
HIV/AIDS;</text>
</subparagraph><after-quoted-block>;</after-quoted-block></quoted-block>
</subparagraph><subparagraph id="id04262b00-11aa-4d5d-9c6b-20411ce5ef16"><enum>(F)</enum><text>in subparagraph (I), as
redesignated, by striking <quote>and</quote> at the end; and</text>
</subparagraph><subparagraph id="id441fd8e5-3028-4106-95cd-897126c68dd9"><enum>(G)</enum><text>by adding at the end the
following:</text>
<quoted-block changed="added" display-inline="no-display-inline" id="id158ed492-1b03-408c-b07a-9799e1478d25" reported-display-style="italic" style="OLC">
<subparagraph id="id49774640-a00c-4f8a-b6bb-7a400e5461c3"><enum>(K)</enum><text>assistance for
counseling, testing, treatment, care, and support programs, including—</text>
<clause id="id3c9a9b4a-457b-4b2e-b231-5e65faf2d0bf"><enum>(i)</enum><text>counseling and other
services for the prevention of reinfection of individuals with HIV/AIDS;</text>
</clause><clause id="id81496979-a85c-4a6c-b012-2a6e38ac0910"><enum>(ii)</enum><text>counseling to prevent
sexual transmission of HIV, including—</text>
<subclause id="id1a3a65d6-6d58-4712-9614-aa24058d8ad8"><enum>(I)</enum><text>life skills development
for practicing abstinence and faithfulness;</text>
</subclause><subclause id="idb2dc5a37-1445-48a7-93ee-cf44e8e7d37c"><enum>(II)</enum><text>reducing the number of
sexual partners;</text>
</subclause><subclause id="ide8fcdb1e-27d0-4329-9b47-f84bb56dd9a1"><enum>(III)</enum><text>delaying sexual debut;
and</text>
</subclause><subclause id="id17a566a0-1cee-4fdf-a21b-a672cfdbf590"><enum>(IV)</enum><text>ensuring correct and
consistent use of condoms;</text>
</subclause></clause><clause id="id20dfad2f-fc2f-4415-8a7d-2dbfd08a37c2"><enum>(iii)</enum><text>assistance to engage
underlying vulnerabilities to HIV/AIDS, especially those of women and
girls;</text>
</clause><clause id="id2cb773f1-72d6-4aae-a205-ac21a80b9ed4"><enum>(iv)</enum><text>assistance for
appropriate HIV/AIDS education programs and training targeted to prevent the
transmission of HIV among men who have sex with men;</text>
</clause><clause id="ide09e111d-491f-4a47-801b-fc12c07eb6ae"><enum>(v)</enum><text>assistance to provide
male and female condoms;</text>
</clause><clause id="id062025b6-9f4f-499a-a08a-8c4c15a0bc08"><enum>(vi)</enum><text>diagnosis and treatment
of other sexually transmitted infections;</text>
</clause><clause id="id9f167368-9ae2-407c-9a85-cdcb5c32c4a2"><enum>(vii)</enum><text>strategies to address
the stigma and discrimination that impede HIV/AIDS prevention efforts;
and</text>
</clause><clause id="id69eb5eac-a338-48b3-8746-d55206dde3dc"><enum>(viii)</enum><text>assistance to
facilitate widespread access to microbicides for HIV prevention, if safe and
effective products become available, including financial and technical support
for culturally appropriate introductory programs, procurement, distribution,
logistics management, program delivery, acceptability studies, provider
training, demand generation, and postintroduction
monitoring.</text>
</clause></subparagraph><after-quoted-block>;
and</after-quoted-block></quoted-block>
</subparagraph></paragraph><paragraph id="idac72482f-bee5-46af-a613-d907da31007d"><enum>(2)</enum><text>in paragraph (2)—</text>
<subparagraph id="id2174f03d-0342-4f86-bd13-1827361b9ab0"><enum>(A)</enum><text>in subparagraph (B), by
striking <quote>and</quote> at the end;</text>
</subparagraph><subparagraph id="id79e39cdd-18fd-4a53-bc9a-119920265cf5"><enum>(B)</enum><text>in subparagraph
(C)—</text>
<clause id="id418c1b92-a069-437f-a160-d9e446c4b70c"><enum>(i)</enum><text>by inserting <quote>pain
management,</quote> after <quote>opportunistic infections,</quote>; and</text>
</clause><clause id="id9610dcfd-ea16-469b-8fc4-3fef389921ce"><enum>(ii)</enum><text>by striking the period
at the end and inserting a semicolon; and</text>
</clause></subparagraph><subparagraph id="id0aeda733-d2d2-4b06-a897-908b9bc7808e"><enum>(C)</enum><text>by adding at the end the
following:</text>
<quoted-block changed="added" display-inline="no-display-inline" id="id327e4d83-c2a9-4631-83d5-02b106f30240" reported-display-style="italic" style="OLC">
<subparagraph id="id35092d83-2d94-4c03-984a-5bfba3785a5b"><enum>(D)</enum><text>as part of care and
treatment of HIV/AIDS, assistance (including prophylaxis and treatment) for
common HIV/AIDS-related opportunistic infections for free or at a rate at which
it is easily affordable to the individuals and populations being served;</text>
</subparagraph><subparagraph id="idcb10dbbe-32f5-4f77-b8f8-ceda32d9bcfc"><enum>(E)</enum><text>as part of care and
treatment of HIV/AIDS, assistance or referral to available and adequately
resourced service providers for nutritional support, including counseling and
where necessary the provision of commodities, for persons meeting
malnourishment criteria and their
families;</text>
</subparagraph><after-quoted-block>;</after-quoted-block></quoted-block>
</subparagraph></paragraph><paragraph id="idb0591a23-f737-402f-baa1-dfaa05fe95da"><enum>(3)</enum><text>in paragraph (4)—</text>
<subparagraph id="idb4a5cf17-473c-4eca-b5a9-e146d8e8fd41"><enum>(A)</enum><text>in subparagraph (C), by
striking <quote>and</quote> at the end;</text>
</subparagraph><subparagraph id="id833e973c-19b9-4529-a567-b12f7ef0d306"><enum>(B)</enum><text>in subparagraph (D), by
striking the period at the end and inserting a semicolon; and</text>
</subparagraph><subparagraph id="idc3d3ed8a-13ae-48e0-8702-e4e59482e661"><enum>(C)</enum><text>by adding at the end the
following:</text>
<quoted-block changed="added" display-inline="no-display-inline" id="idcf871462-9f3f-4897-a284-4558c4977311" reported-display-style="italic" style="OLC">
<subparagraph id="id389bdf94-f3b9-4145-8e10-1f576c8c9b22"><enum>(E)</enum><text>carrying out and
expanding program monitoring, impact evaluation research and analysis, and
operations research and disseminating data and findings through mechanisms to
be developed by the Coordinator of United States Government Activities to
Combat HIV/AIDS Globally, in coordination with the Director of the Centers for
Disease Control, in order to—</text>
<clause id="id6dbbe121-e57b-43d7-9c80-fa89ac6a4d40"><enum>(i)</enum><text>improve accountability,
increase transparency, and ensure the delivery of evidence-based services
through the collection, evaluation, and analysis of data regarding
gender-responsive interventions, disaggregated by age and sex;</text>
</clause><clause id="id8d4193b5-83ba-4880-8f93-b461d8d1233f"><enum>(ii)</enum><text>identify and replicate
effective models; and</text>
</clause><clause id="id053788cf-fe46-487e-b302-86816b28e5a6"><enum>(iii)</enum><text>develop gender
indicators to measure outcomes and the impacts of interventions; and</text>
</clause></subparagraph><subparagraph id="ideb82023b-3d61-4314-b36b-f260e1a529ed"><enum>(F)</enum><text>establishing appropriate
systems to—</text>
<clause id="id11dd44bb-6722-4adc-a204-453cb518e70f"><enum>(i)</enum><text>gather epidemiological
and social science data on HIV; and</text>
</clause><clause id="idb29884b1-f382-4f3b-8a45-8da1297a936a"><enum>(ii)</enum><text>evaluate the
effectiveness of prevention efforts among men who have sex with men, with due
consideration to stigma and risks associated with
disclosure.</text>
</clause></subparagraph><after-quoted-block>;</after-quoted-block></quoted-block>
</subparagraph></paragraph><paragraph id="id1770cd14-c578-414b-bf22-b1167e73d18b"><enum>(4)</enum><text>in paragraph (5)—</text>
<subparagraph id="ida162d20f-6e88-4721-991e-43c22bdc8891"><enum>(A)</enum><text>by redesignating
subparagraph (C) as subparagraph (D); and</text>
</subparagraph><subparagraph id="id0d85edd4-95af-409a-81cf-4eb9288d3765"><enum>(B)</enum><text>by inserting after
subparagraph (B) the following:</text>
<quoted-block changed="added" display-inline="no-display-inline" id="id48c7d697-6533-4caa-872d-ee479e55d124" reported-display-style="italic" style="OLC">
<subparagraph id="idcb10cccc-1b0e-4959-b891-5b26d756bf91"><enum>(C)</enum><header>Mechanism to ensure
cost-effective drug purchasing</header><text>Subject to subparagraph (B),
mechanisms to ensure that safe and effective pharmaceuticals, including
antiretrovirals and medicines to treat opportunistic infections, are purchased
at the lowest possible price at which such pharmaceuticals may be obtained in
sufficient quantity on the world market, provided that such pharmaceuticals are
approved, tentatively approved, or otherwise authorized for use by—</text>
<clause id="id7BF64032E35C45C5A32547DA6FCFFE71"><enum>(i)</enum><text>the Food and Drug
Administration;</text>
</clause><clause id="id06E8587484D44E4D990E425B01A3CCE3"><enum>(ii)</enum><text>a stringent regulatory
agency acceptable to the Secretary of Health and Human Services; or</text>
</clause><clause id="id6D1947D328E5491BBA5491B744E94075"><enum>(iii)</enum><text>a quality assurance
mechanism acceptable to the Secretary of Health and Human
Services.</text>
</clause></subparagraph><after-quoted-block>;</after-quoted-block></quoted-block>
</subparagraph></paragraph><paragraph id="id5c5de3fd-9edc-4a88-8267-10d7e6c41ec5"><enum>(5)</enum><text>in paragraph (6)—</text>
<subparagraph id="id3cc624c2-116e-407a-9898-ca3f40be6aa6"><enum>(A)</enum><text>by amending the paragraph
heading to read as follows:</text>
<quoted-block changed="added" display-inline="no-display-inline" id="idaaa1ac63-d317-4aa1-a9ae-fb78f9bf520c" reported-display-style="italic" style="OLC">
<paragraph id="id20ffd181-428f-4063-ae29-06cd09e62109"><enum>(6)</enum><header>Related and coordinated
activities</header>
</paragraph><after-quoted-block>;</after-quoted-block></quoted-block>
</subparagraph><subparagraph id="idec361d98-3d1c-497a-a263-2e8162726ae6"><enum>(B)</enum><text>in subparagraph (B), by
striking <quote>and</quote> at the end;</text>
</subparagraph><subparagraph id="id97cb6db8-6c2d-45b3-a592-058e295910ce"><enum>(C)</enum><text>in subparagraph (C), by
striking the period at the end and inserting <quote>; and</quote>; and</text>
</subparagraph><subparagraph id="id97f3378e-f0c0-4d7f-ae73-daa416b7392a"><enum>(D)</enum><text>by adding at the end the
following:</text>
<quoted-block changed="added" display-inline="no-display-inline" id="id857e98b1-46b2-444c-91c7-90e50cb4baa4" reported-display-style="italic" style="OLC">
<subparagraph id="idcd67eb3f-a846-4fc2-ae48-15e3bf68627e"><enum>(D)</enum><text>coordinated or referred
activities to—</text>
<clause id="id6ee0f7d2-431e-40ee-943b-0136a61d0980"><enum>(i)</enum><text>enhance the clinical
impact of HIV/AIDS care and treatment; and</text>
</clause><clause id="id4d39c88e-f006-484c-acb2-f756665934bb"><enum>(ii)</enum><text>ameliorate the adverse
social and economic costs often affecting AIDS-impacted families and
communities through the direct provision, as necessary, or through the
referral, if possible, of support services, including—</text>
<subclause id="idb3da28ca-4fc0-4dca-b77f-de77bb33e911"><enum>(I)</enum><text>nutritional and food
support;</text>
</subclause><subclause id="id2430596641FC4B39871788DADE16D5CE"><enum>(II)</enum><text>safe drinking water and
adequate sanitation;</text>
</subclause><subclause id="id78b8a0f2-3ebc-4df6-806a-431dc8b61a2f"><enum>(III)</enum><text>nutritional
counseling;</text>
</subclause><subclause id="idfc1258aa-3b32-41ce-bc99-400e84c9126c"><enum>(IV)</enum><text>income-generating
activities and livelihood initiatives;</text>
</subclause><subclause id="idbcbaf09b-7419-4762-a6c4-c3f86f5be2f1"><enum>(V)</enum><text>maternal and child health
care;</text>
</subclause><subclause id="id785a4d55-27ef-48ea-b0f9-280c5f72e1cf"><enum>(VI)</enum><text>primary health
care;</text>
</subclause><subclause id="id1e2db7b5-26a6-4fb5-9be9-6440e259ac83"><enum>(VII)</enum><text>the diagnosis and
treatment of other infectious or sexually transmitted diseases;</text>
</subclause><subclause id="id9283ca3b-e32c-4451-999c-b8365259302c"><enum>(VIII)</enum><text>substance abuse and
treatment services; and</text>
</subclause><subclause id="idf68ffab1-4746-4c30-9b21-24183fa235d5"><enum>(IX)</enum><text>legal services;</text>
</subclause></clause></subparagraph><subparagraph id="ida23d7801-52e4-4470-960e-1298c0121b5f"><enum>(E)</enum><text>coordinated or referred
activities to link programs addressing HIV/AIDS with programs addressing
gender-based violence in areas of significant HIV prevalence to assist
countries in the development and enforcement of women’s health, children’s
health, and HIV/AIDS laws and policies that—</text>
<clause id="id1b179ed6-d535-4aa5-a3a7-4b7a963a3cf9"><enum>(i)</enum><text>prevent and respond to
violence against women and girls;</text>
</clause><clause id="idb789f0f7-3c02-4705-821f-e75c90051406"><enum>(ii)</enum><text>promote the integration
of screening and assessment for gender-based violence into HIV/AIDS
programming;</text>
</clause><clause id="idb373a133-1574-420d-ae02-012ae859bdc4"><enum>(iii)</enum><text>promote appropriate
HIV/AIDS counseling, testing, and treatment into gender-based violence
programs; and</text>
</clause><clause id="id63e95b5e-e645-4ef2-a37a-d6af2af142de"><enum>(iv)</enum><text>assist governments to
develop partnerships with civil society organizations to create networks for
psychosocial, legal, economic, or other support services;</text>
</clause></subparagraph><subparagraph id="id4493bec9-3921-43bf-b18a-31ddeb7835e7"><enum>(F)</enum><text>coordinated or referred
activities to—</text>
<clause id="id7f9c5f4c-d630-44fe-9c2a-8958f6406d8d"><enum>(i)</enum><text>address the frequent
coinfection of HIV and tuberculosis, in accordance with World Health
Organization guidelines;</text>
</clause><clause id="id52b3c768-1170-4fa4-81fb-223af8c2a3ce"><enum>(ii)</enum><text>promote
provider-initiated or <quote>opt-out</quote> HIV/AIDS counseling and testing
and appropriate referral for treatment and care to individuals with
tuberculosis or its symptoms, particularly in areas with significant HIV
prevalence; and</text>
</clause><clause id="id3fcb94d9-e1b7-42d5-adbe-3c35d6c64734"><enum>(iii)</enum><text>strengthen programs to
ensure that individuals testing positive for HIV receive tuberculosis screening
and to improve laboratory capacities, infection control, and adherence;
and</text>
</clause></subparagraph><subparagraph id="id2b57dba1-ba70-47b3-aeec-7b4bd8469cb2"><enum>(G)</enum><text>activities to—</text>
<clause id="id61938fa9-6c61-4fd5-afe6-cce38a539e5c"><enum>(i)</enum><text>improve the effectiveness
of national responses to HIV/AIDS;</text>
</clause><clause id="idcec82236-0b24-4918-bf5a-58e8239de41e"><enum>(ii)</enum><text>strengthen overall
health systems in high-prevalence countries, including support for workforce
training, retention, and effective deployment, capacity building, laboratory
development, equipment maintenance and repair, and public health and related
public financial management systems and operations; and</text>
</clause><clause id="id1D08D192B62B4979B0CBD60F67AADCFA"><enum>(iii)</enum><text>encourage fair and
transparent procurement practices among partner countries; and</text>
</clause><clause commented="no" display-inline="no-display-inline" id="id2D9B98430C7A4C3290622640471B24E0"><enum>(iv)</enum><text display-inline="yes-display-inline">promote in-country or intra-regional
pediatric training for physicians and other health professionals, preferably
through public-private partnerships involving colleges and universities, with
the goal of increasing pediatric HIV workforce
capacity.</text>
</clause></subparagraph><after-quoted-block>;
and</after-quoted-block></quoted-block>
</subparagraph></paragraph><paragraph id="id0496bda6-37bb-4faf-85bb-7247b24a31c0"><enum>(6)</enum><text>by adding at the end the
following:</text>
<quoted-block changed="added" display-inline="no-display-inline" id="id3c3d9c05-e9f9-4347-bbe5-ffbe3237d48f" reported-display-style="italic" style="OLC">
<paragraph id="id623abd2e-f5d9-489b-993d-c5395f9ef7b4"><enum>(8)</enum><header>Compacts and framework
agreements</header><text>The development of compacts or framework agreements,
tailored to local circumstances, with national governments or regional
partnerships in countries with significant HIV/AIDS burdens to promote host
government commitment to deeper integration of HIV/AIDS services into health
systems, contribute to health systems overall, and enhance sustainability,
including—</text>
<subparagraph id="idCB008A85D55440B2957AA8AFED9EEEAF"><enum>(A)</enum><text>cost sharing assurances
that meet the requirements under section 110; and</text>
</subparagraph><subparagraph id="idD2FFD34664F64F97ABEFEC9AA402A15A"><enum>(B)</enum><text>transition strategies to
ensure sustainability of such programs and activities, including health care
systems, under other international donor support, or budget support by
respective foreign
governments.</text>
</subparagraph></paragraph><after-quoted-block>.</after-quoted-block></quoted-block>
</paragraph></subsection><subsection id="ida1d8f2e2-2bf2-4072-a7a7-0f48c9b6c2b7"><enum>(d)</enum><header>Compacts and framework
agreements</header><text>Section 104A of such Act is amended—</text>
<paragraph id="id869fe844-b1d4-49c0-bca2-1986ddb49503"><enum>(1)</enum><text>by redesignating
subsections (e) through (g) as subsections (f) through (h); and</text>
</paragraph><paragraph id="idcb86adb3-a117-49a5-bb03-b1c1bbfd2266"><enum>(2)</enum><text>by inserting after
subsection (d) the following:</text>
<quoted-block changed="added" display-inline="no-display-inline" id="id5cdcdcac-e883-4403-ac74-0bf0ce28c664" reported-display-style="italic" style="OLC">
<subsection id="idad90325e-6f16-4efe-b27c-c4a6c3f48c8a"><enum>(e)</enum><header>Compacts and framework
agreements</header>
<paragraph id="id931b46f2-c940-416f-91b9-b59b18389ba8"><enum>(1)</enum><header>Findings</header><text>Congress
makes the following findings:</text>
<subparagraph id="id170bae74-184a-473f-9013-853e43415054"><enum>(A)</enum><text>The congressionally
mandated Institute of Medicine report entitled <quote>PEPFAR Implementation:
Progress and Promise</quote> states: <quote>The next strategy [of the U.S.
Global AIDS Initiative] should squarely address the needs and challenges
involved in supporting sustainable country HIV/AIDS programs, thereby
transitioning from a focus on emergency relief.</quote>.</text>
</subparagraph><subparagraph id="id6045f458-035e-4bc8-9958-7a412bdd0640"><enum>(B)</enum><text>One mechanism to promote
the transition from an emergency to a public health and development approach to
HIV/AIDS is through compacts or framework agreements between the United States
Government and each participating nation.</text>
</subparagraph></paragraph><paragraph id="IDf915c6af5f5b470d91ee120812b9f279"><enum>(2)</enum><header>Elements</header><text>Compacts
on HIV/AIDS authorized under subsection (d)(8) shall include the following
elements:</text>
<subparagraph id="ID9addc5015f1c4f7387b3c7cd44a9e610"><enum>(A)</enum><text>Compacts whose primary
purpose is to provide direct services to combat HIV/AIDS are to be made
between—</text>
<clause id="id0648AAA1E1FC45959DE49B34914E6C96"><enum>(i)</enum><text>the United States
Government; and</text>
</clause><clause id="id3A1B7B5E18CB4128B863F658AA5E396A"><enum>(ii)</enum><subclause commented="no" display-inline="yes-display-inline" id="id1FB03BF6122544CC835622E959D8E8F8"><enum>(I)</enum><text>national or regional
entities representing low-income countries served by an existing United States
Agency for International Development or Department of Health and Human Services
presence or regional platform; or</text>
</subclause><subclause changed="added" id="idCE052E89AF824D13A20E75F700D7249C" indent="up1" reported-display-style="italic"><enum>(II)</enum><text>countries or
regions—</text>
<item id="ID99daaf753c494d23b84c6e86f30a31e7"><enum>(aa)</enum><text>experiencing
significantly high HIV prevalence or risk of significantly increasing incidence
within the general population;</text>
</item><item id="ID703af345de85492a8ef9f6db2dcc913f"><enum>(bb)</enum><text>served by an existing
United States Agency for International Development or Department of Health and
Human Services presence or regional platform; and</text>
</item><item id="ID638609c2ac364647a124c78d3b26863a"><enum>(cc)</enum><text>that
have inadequate financial means within such country or region.</text>
</item></subclause></clause></subparagraph><subparagraph id="ID5454bfb10bfb48c1907351284e5c9640"><enum>(B)</enum><text>Compacts whose primary
purpose is to provide limited technical assistance to a country or region
connected to services provided within the country or region—</text>
<clause id="idA99456F3CF0846A8A950EB7DE849E391"><enum>(i)</enum><text>may be made with other
countries or regional entities served by an existing United States Agency for
International Development or Department of Health and Human Services presence
or regional platform;</text>
</clause><clause id="id93F8BE6A62054FD9ABFD9C15691687E5"><enum>(ii)</enum><text>shall require
significant investments in HIV prevention, care, and treatment services by the
host country;</text>
</clause><clause id="id33615E88E0CD4E9AAAB49BFCC1BDE256"><enum>(iii)</enum><text>shall be time-limited
in terms of United States contributions; and</text>
</clause><clause id="id4E2582595AAE4E3EACD5A8368C479ACC"><enum>(iv)</enum><text>shall be made only upon
prior notification to Congress—</text>
<subclause id="id73621317CCB6476F8D34ACD6F5B26C73"><enum>(I)</enum><text>justifying the need for
such compacts;</text>
</subclause><subclause id="id1AC4F5A13DE047D9BFBC0425F52744DB"><enum>(II)</enum><text>describing the expected
investment by the country or regional entity; and</text>
</subclause><subclause id="id5FC4043BBF0F44DFACF5C803DA08C689"><enum>(III)</enum><text>describing the scope,
nature, expected total United States investment, and time frame of the limited
technical assistance under the compact and its intended impact.</text>
</subclause></clause></subparagraph><subparagraph id="IDfe2ec86d62bc406abd5626f9a9a52b6c"><enum>(C)</enum><text>Compacts shall include
provisions to—</text>
<clause id="idD483AC210FBC45F490C4521ACD8FEB79"><enum>(i)</enum><text>promote local and
national efforts to reduce stigma associated with HIV/AIDS; and</text>
</clause><clause id="id9196951D443D44B88B71D7ECCEE5B639"><enum>(ii)</enum><text>work with and promote
the role of civil society in combating HIV/AIDS.</text>
</clause></subparagraph><subparagraph id="IDdcc1f49febfe4cc9beab7e021d098b19"><enum>(D)</enum><text>Compacts shall take into
account the overall national health and development and national HIV/AIDS and
public health strategies of each country.</text>
</subparagraph><subparagraph id="idE54BD01799D04B8191160A58A47AC97C"><enum>(E)</enum><text>Compacts shall
contain—</text>
<clause id="ID263054550e2a488f90407a5dc426aa63"><enum>(i)</enum><text>consideration of the
specific objectives that the country and the United States expect to achieve
during the term of a compact;</text>
</clause><clause id="IDceefb51211d84bac9810b2d8e50f461e"><enum>(ii)</enum><text>consideration of the
respective responsibilities of the country and the United States in the
achievement of such objectives;</text>
</clause><clause id="ID2d7649c3ab44414089f67cd0613cff62"><enum>(iii)</enum><text>consideration of
regular benchmarks to measure progress toward achieving such objectives;</text>
</clause><clause id="IDe7f07fc57c874c0d8d0993546a41b552"><enum>(iv)</enum><text>an identification of the
intended beneficiaries, disaggregated by gender and age, and including
information on orphans and vulnerable children, to the maximum extent
practicable;</text>
</clause><clause id="IDd0de8e51ff2e4964bd1bf39eb720d164"><enum>(v)</enum><text>consideration of the
methods by which the compact is intended to—</text>
<subclause id="idAF8407557CE143319CA6ED062ADAD84E"><enum>(I)</enum><text>address the factors that
put women and girls at greater risk of HIV/AIDS; and</text>
</subclause><subclause id="idE82F4DC6D5034A959A7A606DBB415215"><enum>(II)</enum><text>strengthen elements such
as the economic, educational, and social status of women, girls, orphans, and
vulnerable children and the inheritance rights and safety of such
individuals;</text>
</subclause></clause><clause id="ID67ea8d0175c54b6d88d0314a10c2d973"><enum>(vi)</enum><text>consideration of the
methods by which the compact will—</text>
<subclause id="idE4F3681D44EB47FF8B8F1BD48170080F"><enum>(I)</enum><text>strengthen the health
care capacity, including factors such as the training, retention, deployment,
recruitment, and utilization of health care workers;</text>
</subclause><subclause id="id5795075F0B4E45528394A7C827BF08FB"><enum>(II)</enum><text>improve supply chain
management; and</text>
</subclause><subclause id="id27FF8C2764E747E5AD5FCCBFB4E1B047"><enum>(III)</enum><text>improve the health
systems and infrastructure of the partner country, including the ability of
compact participants to maintain and operate equipment transferred or purchased
as part of the compact;</text>
</subclause></clause><clause id="ID2846c9857e8d4c718615d540af2b1dfe"><enum>(vii)</enum><text>consideration of
proposed mechanisms to provide oversight;</text>
</clause><clause id="ID50694f7eec684ffe80d733644f112e4e"><enum>(viii)</enum><text>consideration of the
role of civil society in the development of a compact and the achievement of
its objectives;</text>
</clause><clause id="ID616c6353ed304e6abdbf31c738c5c48b"><enum>(ix)</enum><text>a description of the
current and potential participation of other donors in the achievement of such
objectives, as appropriate; and</text>
</clause><clause id="ID8ad1f9f9863c42588f8ede2c20895095"><enum>(x)</enum><text>consideration of a plan
to ensure appropriate fiscal accountability for the use of assistance.</text>
</clause></subparagraph><subparagraph id="idF49E9339494E473B96BA0C3303BDBDC8"><enum>(F)</enum><text>For regional compacts,
priority shall be given to countries that are included in regional funds and
programs in existence as of the date of the enactment of the
<short-title>Tom Lantos and Henry J. Hyde United States
Global Leadership Against HIV/AIDS, Tuberculosis, and Malaria Reauthorization
Act of 2008</short-title>.</text>
</subparagraph><subparagraph id="id04B771C154E34053ACC5E2929D8929BE"><enum>(G)</enum><text>Amounts made available
for compacts described in subparagraphs (A) and (B) shall be subject to the
inclusion of—</text>
<clause id="idE75571E54D3C4B38BA2EF8C040AD1EFC"><enum>(i)</enum><text>cost sharing assurances
that meet the requirements under section 110; and</text>
</clause><clause id="idB97E7A5D28F6475897EB3835A8F2C8B3"><enum>(ii)</enum><text>transition strategies to
ensure sustainability of such programs and activities, including health care
systems, under other international donor support, and budget support by
respective foreign governments.</text>
</clause></subparagraph></paragraph><paragraph id="IDab776a4809d54964a90fc7ab91521631"><enum>(3)</enum><header>Local
input</header><text>In entering into a compact on HIV/AIDS authorized under
subsection (d)(8), the Coordinator of United States Government Activities to
Combat HIV/AIDS Globally shall seek to ensure that the government of a
country—</text>
<subparagraph id="ID5ee9e01e85d644bfbc3080527c827312"><enum>(A)</enum><text>takes into account the
local perspectives of the rural and urban poor, including women, in each
country; and</text>
</subparagraph><subparagraph id="IDf27e2976cb51463bb6bbfec6d0346d7a"><enum>(B)</enum><text>consults with private and
voluntary organizations, including faith-based organizations, the business
community, and other donors in the country.</text>
</subparagraph></paragraph><paragraph id="idc6d5e7df-1c98-40d4-92a1-880ee2299534"><enum>(4)</enum><header>Congressional and
public notification after entering into a compact</header><text>Not later than
10 days after entering into a compact authorized under subsection (d)(8), the
Global AIDS Coordinator shall—</text>
<subparagraph id="id3a3a64d0-05fb-40bc-b8fc-7816fde6f2b4"><enum>(A)</enum><text>submit a report
containing a detailed summary of the compact and a copy of the text of the
compact to—</text>
<clause id="id6053810a-cab4-4d2c-95fb-c72b53d90854"><enum>(i)</enum><text>the
<committee-name committee-id="SSFR00">Committee on Foreign Relations of the
Senate</committee-name>;</text>
</clause><clause id="id6431f518-e8d0-4fa2-b340-4ef4d788f318"><enum>(ii)</enum><text>the
<committee-name committee-id="SSAP00">Committee on Appropriations of the
Senate</committee-name>;</text>
</clause><clause id="id43ffacf2-dd78-41eb-b3ad-1ef13112d32c"><enum>(iii)</enum><text>the
<committee-name committee-id="">Committee on Foreign Affairs of the House of
Representatives</committee-name>; and</text>
</clause><clause id="id7b9d8dbf-c590-40ca-a0c5-e4560a82cc0c"><enum>(iv)</enum><text>the
<committee-name committee-id="">Committee on Appropriations of the House of
Representatives</committee-name>; and</text>
</clause></subparagraph><subparagraph id="id8c931cac-1d25-46ee-b4b6-ae5d9dd08ee9"><enum>(B)</enum><text>publish such information
in the Federal Register and on the Internet website of the Office of the Global
AIDS
Coordinator.</text>
</subparagraph></paragraph></subsection><after-quoted-block>.</after-quoted-block></quoted-block>
</paragraph></subsection><subsection id="id26ac41a6-186c-40e7-9b60-2ba34918ed94"><enum>(e)</enum><header>Annual
report</header><text>Section 104A(f) of such Act, as redesignated, is
amended—</text>
<paragraph id="id56f5d8af-3c6b-457b-a6b1-8732066a7d7d"><enum>(1)</enum><text>in paragraph (1), by
striking <quote>Committee on International Relations</quote> and inserting
<quote>Committee on Foreign Affairs</quote>; and</text>
</paragraph><paragraph id="idcb0c0090-77a1-4ab9-8380-3b351f712feb"><enum>(2)</enum><text>in paragraph (2)—</text>
<subparagraph id="idcbb6752e-d0df-47a0-9cf7-c74a8830ed71"><enum>(A)</enum><text>in subparagraph (B), by
striking <quote>and</quote> at the end;</text>
</subparagraph><subparagraph id="id50fcd38f-37f6-4ca4-a2ab-83b0c79c5b37"><enum>(B)</enum><text>by striking subparagraph
(C) and inserting the following:</text>
<quoted-block changed="added" display-inline="no-display-inline" id="ide7aea79c-478b-442a-8c53-2eff12d59f07" reported-display-style="italic" style="OLC">
<subparagraph id="id8adeef47-0506-41d4-b180-0b3af9f71c11"><enum>(C)</enum><text>a detailed breakdown of
funding allocations, by program and by country, for prevention activities;
and</text>
</subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="id5432b22c-34f8-4d4c-b4ff-96c5be992da0"><enum>(D)</enum><text display-inline="yes-display-inline">a detailed assessment of the impact of
programs established pursuant to such sections, including—</text>
<clause commented="no" display-inline="no-display-inline" id="id448ab8ce-28a8-4a23-877e-967bc70a6223"><enum>(i)</enum><subclause commented="no" display-inline="yes-display-inline" id="id8731cad6-8a12-43ef-8c03-396c0113c304"><enum>(I)</enum><text>the effectiveness
of such programs in reducing—</text>
<item changed="added" commented="no" display-inline="no-display-inline" id="idec84a0c9-381f-4bdd-87e2-15e754141933" indent="up1" reported-display-style="italic"><enum>(aa)</enum><text>the transmission of HIV,
particularly in women and girls;</text>
</item><item changed="added" commented="no" display-inline="no-display-inline" id="id9b4a5aae-0513-4983-bcb9-972688e06c04" indent="up1" reported-display-style="italic"><enum>(bb)</enum><text>mother-to-child
transmission of HIV, including through drug treatment and therapies, either
directly or by referral; and</text>
</item><item changed="added" commented="no" display-inline="no-display-inline" id="idc5345150-41c1-437a-8bc4-9d2695bd17e7" indent="up1" reported-display-style="italic"><enum>(cc)</enum><text>mortality rates from
HIV/AIDS;</text>
</item></subclause><subclause changed="added" id="id2ffa9d14-c4ec-4b04-a211-67efbc114c10" indent="up1" reported-display-style="italic"><enum>(II)</enum><text>the
number of patients receiving treatment for AIDS in each country that receives
assistance under this Act;</text>
</subclause><subclause changed="added" id="id09a527ec-4c00-4226-91c3-1e501282ba15" indent="up1" reported-display-style="italic"><enum>(III)</enum><text>an
assessment of progress towards the achievement of annual goals set forth in the
timetable required under the 5-year strategy established under section 101 of
the <short-title>United States Leadership Against
HIV/AIDS, Tuberculosis, and Malaria Act of 2003</short-title> and, if annual
goals are not being met, the reasons for such failure; and</text>
</subclause><subclause changed="added" id="id17f3c5d2-2932-4fe8-bda2-8db6d3f67a42" indent="up1" reported-display-style="italic"><enum>(IV)</enum><text>retention and attrition
data for programs receiving United States assistance, including mortality and
loss to follow-up rates, organized overall and by country;</text>
</subclause></clause><clause commented="no" display-inline="no-display-inline" id="idd93922b6-60fa-4901-abe2-25ce5b3b79d9"><enum>(ii)</enum><text>the progress made
toward—</text>
<subclause commented="no" display-inline="no-display-inline" id="id4b831945-885e-4445-8303-4c82752fae2f"><enum>(I)</enum><text>improving health care
delivery systems (including the training of health care workers, including
doctors, nurses, midwives, pharmacists, laboratory technicians, and compensated
community health workers, and the use of codes of conduct for ethical
recruiting practices for health care workers);</text>
</subclause><subclause commented="no" display-inline="no-display-inline" id="idd9cbe11e-ed46-4e6d-bacc-8857cd36d4c4"><enum>(II)</enum><text>advancing safe working
conditions for health care workers; and</text>
</subclause><subclause commented="no" display-inline="no-display-inline" id="idb95d9bd8-1b12-4b7e-a792-54c29b35f878"><enum>(III)</enum><text>improving
infrastructure to promote progress toward universal access to HIV/AIDS
prevention, treatment, and care by 2013;</text>
</subclause></clause><clause id="id8a8a65d0-6024-4c3c-b383-902188f303b3"><enum>(iii)</enum><text>a description of
coordination efforts with relevant executive branch agencies to link HIV/AIDS
clinical and social services with non-HIV/AIDS services as part of the United
States health and development agenda;</text>
</clause><clause id="ideee40825-6354-47ac-849b-8ffbd9bcc290"><enum>(iv)</enum><text>a detailed description
of integrated HIV/AIDS and food and nutrition programs and services,
including—</text>
<subclause id="id6602e9fc-930e-4e2d-83fc-3392a54b753b"><enum>(I)</enum><text>the amount spent on food
and nutrition support;</text>
</subclause><subclause id="id4ac56b6e-5c2e-4de4-a0ec-19b39d8053b5"><enum>(II)</enum><text>the types of activities
supported; and</text>
</subclause><subclause id="idb09c6f0b-2205-4581-a696-080510ee87a0"><enum>(III)</enum><text>an assessment of the
effectiveness of interventions carried out to improve the health status of
persons with HIV/AIDS receiving food or nutritional support;</text>
</subclause></clause><clause id="id5aedb9f6-ff78-4957-bda2-378a4668e423"><enum>(v)</enum><text>a description of efforts
to improve harmonization, in terms of relevant executive branch agencies,
coordination with other public and private entities, and coordination with
partner countries’ national strategic plans as called for in the <quote>Three
Ones</quote>;</text>
</clause><clause id="id3d14eb78-123e-4313-a126-8a3dd66e86f1"><enum>(vi)</enum><text>a description of—</text>
<subclause id="id78271a7e-1ec1-410a-9409-64bc605e15e6"><enum>(I)</enum><text>the efforts of partner
countries that were signatories to the Abuja Declaration on HIV/AIDS,
Tuberculosis and Other Related Infectious Diseases to adhere to the goals of
such Declaration in terms of investments in public health, including HIV/AIDS;
and</text>
</subclause><subclause id="id5d6a80e2-d963-4f66-98c3-43315ac8c0a7"><enum>(II)</enum><text>a description of the
HIV/AIDS investments of partner countries that were not signatories to such
Declaration;</text>
</subclause></clause><clause id="ida002f225-2b1a-4973-88e2-65eac2f8a889"><enum>(vii)</enum><text>a detailed description
of any compacts or framework agreements reached or negotiated between the
United States and any partner countries, including a description of the
elements of compacts described in subsection (e);</text>
</clause><clause id="id60b30fa9-cf1d-44fe-8787-2745a6603bd7"><enum>(viii)</enum><text>a description of
programs serving women and girls, including—</text>
<subclause id="id01031a83-fefc-4994-83d7-25d447c1406b"><enum>(I)</enum><text>HIV/AIDS prevention
programs that address the vulnerabilities of girls and women to
HIV/AIDS;</text>
</subclause><subclause id="idef94e9a9-c036-4597-b31b-2765462f9c62"><enum>(II)</enum><text>information on the
number of individuals served by programs aimed at reducing the vulnerabilities
of women and girls to HIV/AIDS and data on the types, objectives, and duration
of programs to address these issues;</text>
</subclause><subclause id="idd4b21406-5d30-491e-94c5-45f1759e7133"><enum>(III)</enum><text>information on programs
to address the particular needs of adolescent girls and young women; and</text>
</subclause><subclause id="ide8569d8b-6b06-492f-8cc1-0a9290f68d3e"><enum>(IV)</enum><text>programs to prevent
gender-based violence or to assist victims of gender based violence as part of,
or in coordination with, HIV/AIDS programs;</text>
</subclause></clause><clause id="id4a149875-35cb-400e-b2e0-93ff4d69c7af"><enum>(ix)</enum><text>a description of
strategies, goals, programs, and interventions to—</text>
<subclause id="id145d4c51-256b-47ac-a19e-4e3a225975f9"><enum>(I)</enum><text>address the needs and
vulnerabilities of youth populations;</text>
</subclause><subclause id="id21b96830-1591-4d41-a436-fd36cb647a9c"><enum>(II)</enum><text>expand access among
young men and women to evidence-based HIV/AIDS health care services and HIV
prevention programs, including abstinence education programs; and</text>
</subclause><subclause id="id2874a0c8-43d7-44e9-9041-42ffbe225435"><enum>(III)</enum><text>expand community-based
services to meet the needs of orphans and of children and adolescents affected
by or vulnerable to HIV/AIDS without increasing stigmatization;</text>
</subclause></clause><clause id="id22c06fec-a06a-41f2-8e92-72a9c5758c6a"><enum>(x)</enum><text>a description of—</text>
<subclause id="ida6fcfe29-2a13-4a1f-96ef-04561ec33a42"><enum>(I)</enum><text>the specific strategies
funded to ensure the reduction of HIV infection among injection drug
users;</text>
</subclause><subclause id="id84ffd735-a08c-4418-94fa-7095810e44e4"><enum>(II)</enum><text>the number of injection
drug users, by country, reached by such strategies; and</text>
</subclause><subclause id="id2445fbc2-135a-4bf8-b753-cfdf201bd78d"><enum>(III)</enum><text>medication-assisted
drug treatment for individuals with HIV or at risk of HIV;</text>
</subclause></clause><clause commented="no" display-inline="no-display-inline" id="id573b7f0f-d859-4f18-a7d4-600fe56b56d7"><enum>(xi)</enum><text>a detailed description
of program monitoring, operations research, and impact evaluation research,
including—</text>
<subclause commented="no" display-inline="no-display-inline" id="id2f9b30eb-c301-4ca2-adc0-cccb3fa6974b"><enum>(I)</enum><text>the amount of funding
provided for each research type;</text>
</subclause><subclause commented="no" display-inline="no-display-inline" id="idbec62476-45e9-4518-80a8-ea98afd41f50"><enum>(II)</enum><text>an analysis of
cost-effectiveness models; and</text>
</subclause><subclause commented="no" display-inline="no-display-inline" id="id6f41c363-b37a-48cd-aca2-fc56292c648a"><enum>(III)</enum><text>conclusions regarding
the efficiency, effectiveness, and quality of services as derived from previous
or ongoing research and monitoring efforts;</text>
</subclause></clause><clause id="id1D66EEE81EF34366AA9F6966ECC69DBD"><enum>(xii)</enum><text>building capacity to
identify, investigate, and stop nosocomial transmission of infectious diseases,
including HIV and tuberculosis; and</text>
</clause><clause id="id0EA1B2937DDA450E9DE43117C298BC3E"><enum>(xiii)</enum><text>a description of
staffing levels of United States government HIV/AIDS teams in countries with
significant HIV/AIDS programs, including whether or not a full-time coordinator
was on staff for the
year.</text>
</clause></subparagraph><after-quoted-block>.</after-quoted-block></quoted-block>
</subparagraph></paragraph></subsection><subsection id="id6b8c19bd-07f0-4280-8ddb-e0ea803c4587"><enum>(f)</enum><header>Authorization of
appropriations</header><text>Section 301(b) of the
<short-title>United States Leadership Against HIV/AIDS,
Tuberculosis, and Malaria Act of 2003</short-title> (<external-xref legal-doc="usc" parsable-cite="usc/22/7631">22 U.S.C. 7631(b)</external-xref>) is
amended—</text>
<paragraph id="idd03745b2-ff1f-4777-b84d-60b921e3c166"><enum>(1)</enum><text>in paragraph (1), by
striking <quote>fiscal years 2004 through 2008</quote> and inserting
<quote>fiscal years 2009 through 2013</quote>; and</text>
</paragraph><paragraph id="id94fa8a5c-016a-4c37-b83a-01a73aaeb79b"><enum>(2)</enum><text>in paragraph (3), by
striking <quote>fiscal years 2004 through 2008</quote> and inserting
<quote>fiscal years 2009 through 2013</quote>.</text>
</paragraph></subsection><subsection id="idc82b92e7-ac36-43ae-b5e8-a8455289458e"><enum>(g)</enum><header>Relationship To
assistance programs To enhance nutrition</header><text>Section 301(c) of such
Act is amended to read as follows:</text>
<quoted-block changed="added" display-inline="no-display-inline" id="idd35c3371-0b2a-44b6-be41-c13a9e72104a" reported-display-style="italic" style="OLC">
<subsection id="id89f31083-c33a-48cc-83b8-31dd92d76bfd"><enum>(c)</enum><header>Food and nutritional
support</header>
<paragraph id="idf74d5f2f-fcfb-4c20-8fcf-a3a1a1d81359"><enum>(1)</enum><header>In
general</header><text>As indicated in the report produced by the Institute of
Medicine, entitled <quote>PEPFAR Implementation: Progress and Promise</quote>,
inadequate caloric intake has been clearly identified as a principal reason for
failure of clinical response to antiretroviral therapy. In recognition of the
impact of malnutrition as a clinical health issue for many persons living with
HIV/AIDS that is often associated with health and economic impacts on these
individuals and their families, the Global AIDS Coordinator and the
Administrator of the United States Agency for International Development
shall—</text>
<subparagraph id="id87a47d4f-b406-45a8-8596-4f8a46ca32b4"><enum>(A)</enum><text>follow World Health
Organization guidelines for HIV/AIDS food and nutrition services;</text>
</subparagraph><subparagraph id="id4b9797ec-207f-404d-a397-29dfb30249a5"><enum>(B)</enum><text>integrate nutrition
programs with HIV/AIDS activities through effective linkages among the health,
agricultural, and livelihood sectors and establish additional services in
circumstances in which referrals are inadequate or impossible;</text>
</subparagraph><subparagraph id="idf8df2bed-a354-4aa6-96c6-aaa824fc4587"><enum>(C)</enum><text>provide, as a component
of care and treatment programs for persons with HIV/AIDS, food and nutritional
support to individuals infected with, and affected by, HIV/AIDS who meet
established criteria for nutritional support (including clinically malnourished
children and adults, and pregnant and lactating women in programs in need of
supplemental support), including—</text>
<clause id="idc00df8c4-8b32-49a8-be1d-ea31ac4de3ea"><enum>(i)</enum><text>anthropometric and
dietary assessment;</text>
</clause><clause id="idfed56068-9d03-413e-ba5a-b199fedf133b"><enum>(ii)</enum><text>counseling; and</text>
</clause><clause id="id99e8805f-c105-407c-b829-d87b30819457"><enum>(iii)</enum><text>therapeutic and
supplementary feeding;</text>
</clause></subparagraph><subparagraph id="idf6ff39ee-09e9-4d6e-9748-313aa38176a2"><enum>(D)</enum><text>provide food and
nutritional support for children affected by HIV/AIDS and to communities and
households caring for children affected by HIV/AIDS; and</text>
</subparagraph><subparagraph id="id44cc0482-bb4c-48f1-a653-58d9641317e7"><enum>(E)</enum><text>in communities where
HIV/AIDS and food insecurity are highly prevalent, support programs to address
these often intersecting health problems through community-based assistance
programs, with an emphasis on sustainable approaches.</text>
</subparagraph></paragraph><paragraph id="id66a2457b-44c6-4fc1-8147-2aac36622213"><enum>(2)</enum><header>Authorization of
appropriations</header><text>Of the amounts authorized to be appropriated under
section 401, there are authorized to be appropriated to the President such sums
as may be necessary for each of the fiscal years 2009 through 2013 to carry out
this
subsection.</text>
</paragraph></subsection><after-quoted-block>.</after-quoted-block></quoted-block>
</subsection><subsection id="ida2ce90c5-ff30-4948-a8f3-e9d2d54947ab"><enum>(h)</enum><header>Eligibility for
assistance</header><text>Section 301(d) of such Act is amended to read as
follows:</text>
<quoted-block changed="added" display-inline="no-display-inline" id="idca19e1e0-0cd5-4013-b1e7-22a642889821" reported-display-style="italic" style="OLC">
<subsection id="idcd1cb185-a6a5-4ea4-ba5e-f1acaa64f7ff"><enum>(d)</enum><header>Eligibility for
assistance</header><text>An organization, including a faith-based organization,
that is otherwise eligible to receive assistance under section 104A of the
Foreign Assistance Act of 1961, under this Act, or under any amendment made by
this Act or by the <short-title>Tom Lantos and Henry J.
Hyde United States Global Leadership Against HIV/AIDS, Tuberculosis, and
Malaria Reauthorization Act of 2008</short-title>, for HIV/AIDS prevention,
treatment, or care—</text>
<paragraph id="id486108fb-f255-4da0-ac74-f90dd2c8a324"><enum>(1)</enum><text>shall not be required, as
a condition of receiving such assistance—</text>
<subparagraph id="id8f6161dd-a005-40f0-bc86-2ec58ca3f1e3"><enum>(A)</enum><text>to endorse or utilize a
multisectoral or comprehensive approach to combating HIV/AIDS; or</text>
</subparagraph><subparagraph id="idae388802-42dd-4513-a374-3c149053c9f1"><enum>(B)</enum><text>to endorse, utilize, make
a referral to, become integrated with, or otherwise participate in any program
or activity to which the organization has a religious or moral objection;
and</text>
</subparagraph></paragraph><paragraph id="id9694ad5e-c381-4736-9fed-a65871d4c99d"><enum>(2)</enum><text>shall not be
discriminated against in the solicitation or issuance of grants, contracts, or
cooperative agreements under such provisions of law for refusing to meet any
requirement described in paragraph
(1).</text>
</paragraph></subsection><after-quoted-block>.</after-quoted-block></quoted-block>
</subsection></section><section id="id7037e72f-f22e-49eb-977f-7f50da447316"><enum>302.</enum><header>Assistance to combat
tuberculosis</header>
<subsection id="idd52eea0e-3148-4205-af9e-fc1fab5749aa"><enum>(a)</enum><header>Policy</header><text>Section
104B(b) of the Foreign Assistance Act of 1961 (<external-xref legal-doc="usc" parsable-cite="usc/22/2151b-3">22 U.S.C. 2151b–3(b)</external-xref>) is amended
to read as follows:</text>
<quoted-block changed="added" display-inline="no-display-inline" id="id540e1dd5-6e26-42dc-b7af-05d3b8526ae5" reported-display-style="italic" style="OLC">
<subsection id="id0f387305-b628-44f5-98a3-ea67339f8247"><enum>(b)</enum><header>Policy</header><text>It
is a major objective of the foreign assistance program of the United States to
control tuberculosis. In all countries in which the Government of the United
States has established development programs, particularly in countries with the
highest burden of tuberculosis and other countries with high rates of
tuberculosis, the United States should support the objectives of the Global
Plan to Stop TB, including through achievement of the following goals:</text>
<paragraph id="id6eb3c88c-1d9d-4573-bba3-b32ad4300663"><enum>(1)</enum><text>Reduce by half the
tuberculosis death and disease burden from the 1990 baseline.</text>
</paragraph><paragraph id="id37A5A5D5C10E4640BEBD606CEDB3C8A2"><enum>(2)</enum><text>Sustain or exceed the
detection of at least 70 percent of sputum smear-positive cases of tuberculosis
and the successful treatment of at least 85 percent of the cases detected in
countries with established United States Agency for International Development
tuberculosis programs.</text>
</paragraph><paragraph id="id6995C8B1A0A149509A5A6F32222616D1"><enum>(3)</enum><text>In support of the Global
Plan to Stop TB, the President shall establish a comprehensive, 5-year United
States strategy to expand and improve United States efforts to combat
tuberculosis globally, including a plan to support—</text>
<subparagraph id="id53EF2A141D054268A48AAEE3A00C189B"><enum>(A)</enum><text>the successful treatment
of 4,500,000 new sputum smear tuberculosis patients under DOTS programs by
2013, primarily through direct support for needed services, commodities, health
workers, and training, and additional treatment through coordinated
multilateral efforts; and</text>
</subparagraph><subparagraph id="idB8D5C03976984BFCAC1ECB25BF5EE9F1"><enum>(B)</enum><text>the diagnosis and
treatment of 90,000 new multiple drug resistant tuberculosis cases by 2013, and
additional treatment through coordinated multilateral
efforts.</text>
</subparagraph></paragraph></subsection><after-quoted-block>.</after-quoted-block></quoted-block>
</subsection><subsection id="id7dc371a0-46a3-4c8b-9af7-13c816a78183"><enum>(b)</enum><header>Priority To Stop TB
Strategy</header><text>Section 104B(e) of such Act is amended to read as
follows:</text>
<quoted-block changed="added" display-inline="no-display-inline" id="ida402ea40-8c67-40bc-8636-1eb7cf5f9e0f" reported-display-style="italic" style="OLC">
<subsection id="ided6e0873-8e66-4997-90fc-8fca8226d369"><enum>(e)</enum><header>Priority To Stop TB
Strategy</header><text>In furnishing assistance under subsection (c), the
President shall give priority to—</text>
<paragraph id="id0d390455-7474-449f-b236-ff3970687f5f"><enum>(1)</enum><text>direct services described
in the Stop TB Strategy, including expansion and enhancement of Directly
Observed Treatment Short-course (DOTS) coverage, rapid testing, treatment for
individuals infected with both tuberculosis and HIV, and treatment for
individuals with multi-drug resistant tuberculosis (MDR–TB), strengthening of
health systems, use of the International Standards for Tuberculosis Care by all
providers, empowering individuals with tuberculosis, and enabling and promoting
research to develop new diagnostics, drugs, and vaccines, and program-based
operational research relating to tuberculosis; and</text>
</paragraph><paragraph id="ide0fbbc14-ce42-4772-9806-decbb2236fc1"><enum>(2)</enum><text>funding for the Global
Tuberculosis Drug Facility, the Stop Tuberculosis Partnership, and the Global
Alliance for TB Drug
Development.</text>
</paragraph></subsection><after-quoted-block>.</after-quoted-block></quoted-block>
</subsection><subsection id="id33462e68-6d13-41df-95ab-07f553f1ae60"><enum>(c)</enum><header>Assistance for the
World Health Organization and the Stop Tuberculosis
Partnership</header><text>Section 104B of such Act is amended—</text>
<paragraph id="ide5de86cf-783e-4be9-97ff-7ba6e3348ad5"><enum>(1)</enum><text>by redesignating
subsection (f) as subsection (h); and</text>
</paragraph><paragraph id="idc8a344b2-ca61-4755-a1d2-99a50c38f73b"><enum>(2)</enum><text>by inserting after
subsection (e) the following:</text>
<quoted-block changed="added" display-inline="no-display-inline" id="id81576e27-e875-49fd-bd42-2fad04f24597" reported-display-style="italic" style="OLC">
<subsection id="idca2ca203-18fa-43f0-8de4-d17a2948269d"><enum>(f)</enum><header>Assistance for the
World Health Organization and the Stop Tuberculosis
Partnership</header><text>In carrying out this section, the President, acting
through the Administrator of the United States Agency for International
Development, is authorized to provide increased resources to the World Health
Organization and the Stop Tuberculosis Partnership to improve the capacity of
countries with high rates of tuberculosis and other affected countries to
implement the Stop TB Strategy and specific strategies related to addressing
multiple drug resistant tuberculosis (MDR–TB) and extensively drug resistant
tuberculosis
(XDR–TB).</text>
</subsection><after-quoted-block>.</after-quoted-block></quoted-block>
</paragraph></subsection><subsection id="idB7702E6EE49F48279620A7C920FED081"><enum>(d)</enum><header>Annual
report</header><text>Section 104B of such Act is amended by inserting after
subsection (f), as added by subsection (c) of this section, the
following:</text>
<quoted-block changed="added" display-inline="no-display-inline" id="idB4F2E974816B4FD3B03A8E9CBAC497A9" reported-display-style="italic" style="OLC">
<subsection id="id26C6436B215042A7B3D996B03C5AB0EE"><enum>(g)</enum><header>Annual
report</header><text>The President shall submit an annual report to Congress
that describes the impact of United States foreign assistance on efforts to
control tuberculosis, including—</text>
<paragraph id="ID224b108394cd43609b4955ae093c5cd8"><enum>(1)</enum><text>the number of
tuberculosis cases diagnosed and the number of cases cured in countries
receiving United States bilateral foreign assistance for tuberculosis control
purposes;</text>
</paragraph><paragraph id="ID25da1fb22a194f128c3c854fe55dd513"><enum>(2)</enum><text>a description of
activities supported with United States tuberculosis resources in each country,
including a description of how those activities specifically contribute to
increasing the number of people diagnosed and treated for tuberculosis;</text>
</paragraph><paragraph id="IDc542e5a1f0894f8880cc5567579da091"><enum>(3)</enum><text>in each country receiving
bilateral United States foreign assistance for tuberculosis control purposes,
the percentage provided for direct tuberculosis services in countries receiving
United States bilateral foreign assistance for tuberculosis control
purposes;</text>
</paragraph><paragraph id="ID4e756094efd94e11a19d0764c2b34b6c"><enum>(4)</enum><text>a description of research
efforts and clinical trials to develop new tools to combat tuberculosis,
including diagnostics, drugs, and vaccines supported by United States bilateral
assistance;</text>
</paragraph><paragraph id="ID0ac9d125e4814b46b33c5f7b6f61b85f"><enum>(5)</enum><text>the number of persons who
have been diagnosed and started treatment for multidrug-resistant tuberculosis
in countries receiving United States bilateral foreign assistance for
tuberculosis control programs;</text>
</paragraph><paragraph id="ID5d9dfd3116e04d2f9854fb89bf2a205a"><enum>(6)</enum><text>a description of the
collaboration and coordination of United States anti-tuberculosis efforts with
the World Health Organization, the Global Fund, and other major public and
private entities within the Stop TB Strategy;</text>
</paragraph><paragraph id="IDd19b3f3c0ac84156962a4aa32156a06c"><enum>(7)</enum><text>the constraints on
implementation of programs posed by health workforce shortages and
capacities;</text>
</paragraph><paragraph id="IDe22367f3db4f4043b488aad2bb8c5b15"><enum>(8)</enum><text>the number of people
trained in tuberculosis control; and</text>
</paragraph><paragraph id="IDccd6eca91e714ed883b1c3703ba48a2f"><enum>(9)</enum><text>a breakdown of
expenditures for direct patient tuberculosis services, drugs and other
commodities, drug management, training in diagnosis and treatment, health
systems strengthening, research, and support
costs.</text>
</paragraph></subsection><after-quoted-block>.</after-quoted-block></quoted-block>
</subsection><subsection id="id3b777042-f990-49f2-a0c4-4d5341137483"><enum>(e)</enum><header>Definitions</header><text>Section
104B(h) of such Act, as redesignated by subsection (c), is amended—</text>
<paragraph id="id79db87fb-e9db-4737-a7e4-103f519d7123"><enum>(1)</enum><text>in paragraph (1), by
striking the period at the end and inserting the following: “including—</text>
<quoted-block changed="added" display-inline="no-display-inline" id="id7e667ad8-6cc3-49a0-81b2-653472317c04" reported-display-style="italic" style="OLC">
<subparagraph id="idcc49c94c-5e1b-4498-9c64-7d4635de9176"><enum>(A)</enum><text>low-cost and effective
diagnosis, treatment, and monitoring of tuberculosis;</text>
</subparagraph><subparagraph id="idcfc333c8-4f59-4599-bbd9-567a4ecafab7"><enum>(B)</enum><text>a reliable drug
supply;</text>
</subparagraph><subparagraph id="id7239ba86-f567-4437-b368-b240cddecaf7"><enum>(C)</enum><text>a management strategy for
public health systems;</text>
</subparagraph><subparagraph id="ide37b3318-bd3e-4067-bfd4-7bf3a17f642e"><enum>(D)</enum><text>health system
strengthening;</text>
</subparagraph><subparagraph id="id5fecd342-f38f-449d-ad35-a3291f063b02"><enum>(E)</enum><text>promotion of the use of
the International Standards for Tuberculosis Care by all care providers;</text>
</subparagraph><subparagraph id="id86242dad-062f-4412-870a-fb6694f0de91"><enum>(F)</enum><text>bacteriology under an
external quality assessment framework;</text>
</subparagraph><subparagraph id="id86feffca-96c5-499c-be28-60bfe72c6d00"><enum>(G)</enum><text>short-course
chemotherapy; and</text>
</subparagraph><subparagraph id="idfe3da25e-1225-47b2-9c1a-13fff3415a1d"><enum>(H)</enum><text>sound reporting and
recording systems.</text>
</subparagraph><after-quoted-block>;
and</after-quoted-block></quoted-block>
</paragraph><paragraph id="id2a8d0147-13b5-40e3-a36e-db1ae1fccd46"><enum>(2)</enum><text>by redesignating
paragraph (5) as paragraph (6); and</text>
</paragraph><paragraph id="id12e4ad36-8597-4b97-beb8-762c41bf74e3"><enum>(3)</enum><text>by inserting after
paragraph (4) the following:</text>
<quoted-block changed="added" display-inline="no-display-inline" id="id2c626987-c25d-42e8-b3da-b08fad2e7e10" reported-display-style="italic" style="OLC">
<paragraph id="id132e53bd-6a95-4d74-a779-a8cf765473b9"><enum>(5)</enum><header>Stop TB
strategy</header><text>The term <term>Stop TB Strategy</term> means the 6-point
strategy to reduce tuberculosis developed by the World Health Organization,
which is described in the Global Plan to Stop TB 2006–2015: Actions for Life, a
comprehensive plan developed by the Stop TB Partnership that sets out the
actions necessary to achieve the millennium development goal of cutting
tuberculosis deaths and disease burden in half by
2015.</text>
</paragraph><after-quoted-block>.</after-quoted-block></quoted-block>
</paragraph></subsection><subsection id="id54348f63-fd8f-4f5e-b831-6fecce5b02eb"><enum>(f)</enum><header>Authorization of
appropriations</header><text>Section 302 (b) of the
<short-title>United States Leadership Against HIV/AIDS,
Tuberculosis, and Malaria Act of 2003</short-title> (<external-xref legal-doc="usc" parsable-cite="usc/22/7632">22 U.S.C. 7632(b)</external-xref>) is
amended—</text>
<paragraph id="id8b7fb893-9ace-4558-a566-f1131db0f710"><enum>(1)</enum><text>in paragraph (1), by
striking <quote>such sums as may be necessary for each of the fiscal years 2004
through 2008</quote> and inserting <quote>a total of $4,000,000,000 for the
5-year period beginning on October 1, 2008.</quote>; and</text>
</paragraph><paragraph id="id39e309a3-2728-47c0-99ab-810cb0785779"><enum>(2)</enum><text>in paragraph (3), by
striking <quote>fiscal years 2004 through 2008</quote> and inserting
<quote>fiscal years 2009 through 2013.</quote>.</text>
</paragraph></subsection></section><section id="id94ad8a88-494f-4471-bf19-dd9341164cbb"><enum>303.</enum><header>Assistance to combat
malaria</header>
<subsection id="id2efc4c3d-c024-416a-a3b3-fcd58529f680"><enum>(a)</enum><header>Amendment to the
Foreign Assistance Act of 1961</header><text>Section 104C(b) of the Foreign
Assistance Act of 1961 (<external-xref legal-doc="usc" parsable-cite="usc/22/2151-4">22 U.S.C. 2151–4(b)</external-xref>) is amended by inserting
<quote>treatment,</quote> after <quote>control,</quote>.</text>
</subsection><subsection id="id68272be5-e4e4-454f-b161-cbd33121122b"><enum>(b)</enum><header>Authorization of
Appropriations</header><text>Section 303 of the
<short-title>United States Leadership Against HIV/AIDS,
Tuberculosis, and Malaria Act of 2003</short-title>, and Malaria Act of 2003
(<external-xref legal-doc="usc" parsable-cite="usc/22/7633">22 U.S.C. 7633</external-xref>) is amended—</text>
<paragraph id="idb7435233-ff18-4711-b110-f91c70597790"><enum>(1)</enum><text>in subsection (b)—</text>
<subparagraph id="id811829f8-b040-4319-9c93-1be79bc4f953"><enum>(A)</enum><text>in paragraph (1), by
striking <quote>such sums as may be necessary for fiscal years 2004 through
2008</quote> and inserting <quote>$5,000,000,000 during the 5-year period
beginning on October 1, 2008</quote>; and</text>
</subparagraph><subparagraph id="id7b8f394f-e879-4d69-bd5f-74f51be99f9d"><enum>(B)</enum><text>in paragraph (3), by
striking <quote>fiscal years 2004 through 2008</quote> and inserting
<quote>fiscal years 2009 through 2013</quote>; and</text>
</subparagraph></paragraph><paragraph id="idbd35f409-d265-4bf7-b53c-c0732c71e36b"><enum>(2)</enum><text>by adding at the end the
following:</text>
<quoted-block changed="added" display-inline="no-display-inline" id="idf4e7a718-5e89-4c30-a070-99652ae93730" reported-display-style="italic" style="OLC">
<subsection id="id972fff53-0637-4b83-b856-07cce1a9cb62"><enum>(c)</enum><header>Statement of
policy</header><text>Providing assistance for the prevention, control,
treatment, and the ultimate eradication of malaria is—</text>
<paragraph id="idbf5341e0-1937-44d2-86a8-b6a6ed5f86b5"><enum>(1)</enum><text>a major objective of the
foreign assistance program of the United States; and</text>
</paragraph><paragraph id="id279d937f-8f48-489c-b7ff-1e676a3892cf"><enum>(2)</enum><text>1 component of a
comprehensive United States global health strategy to reduce disease burdens
and strengthen communities around the world.</text>
</paragraph></subsection><subsection id="id11e57e6e-079f-4ece-a21e-2011d90bcf7d"><enum>(d)</enum><header>Development of a
Comprehensive 5-Year Strategy</header><text>The President shall establish a
comprehensive, 5-year strategy to combat global malaria that—</text>
<paragraph id="idcd60c1b9-ca00-4dd0-beea-d9060e3bf65b"><enum>(1)</enum><text>strengthens the capacity
of the United States to be an effective leader of international efforts to
reduce malaria burden;</text>
</paragraph><paragraph id="id986ad828-c108-44df-b8d7-c2f770d472c5"><enum>(2)</enum><text>maintains sufficient
flexibility and remains responsive to the ever-changing nature of the global
malaria challenge;</text>
</paragraph><paragraph id="id4ee846de-4710-4f05-b87e-285f6bf7c8c3"><enum>(3)</enum><text>includes specific
objectives and multisectoral approaches and strategies to reduce the
prevalence, mortality, incidence, and spread of malaria;</text>
</paragraph><paragraph id="id3b9087bb-3f34-45ba-b8f8-90093172230d"><enum>(4)</enum><text>describes how this
strategy would contribute to the United States’ overall global health and
development goals;</text>
</paragraph><paragraph id="id83391203-404a-4835-ad8d-84263ce5c6c3"><enum>(5)</enum><text>clearly explains how
outlined activities will interact with other United States Government global
health activities, including the 5-year global AIDS strategy required under
this Act;</text>
</paragraph><paragraph id="id554bdb8c-2603-4963-8e2a-cc264dabed73"><enum>(6)</enum><text>expands public-private
partnerships and leverage of resources;</text>
</paragraph><paragraph id="idee080ee5-42cd-4df0-843d-2dad4d3de00b"><enum>(7)</enum><text>coordinates among
relevant Federal agencies to maximize human and financial resources and to
reduce duplication among these agencies, foreign governments, and international
organizations;</text>
</paragraph><paragraph id="idaa8f0879-9a29-4f01-80a9-1e2c8d5659fa"><enum>(8)</enum><text>coordinates with other
international entities, including the Global Fund;</text>
</paragraph><paragraph id="id937a9be1-8b6d-4599-bc7e-09cd631ef6b6"><enum>(9)</enum><text>maximizes United States
capabilities in the areas of technical assistance and training and research,
including vaccine research; and</text>
</paragraph><paragraph id="id241c8464-0e0d-4e69-bf27-494b364c51fc"><enum>(10)</enum><text>establishes priorities
and selection criteria for the distribution of resources based on factors such
as—</text>
<subparagraph id="id9d6363ef-2ada-4c9c-bfc0-4d7cc374e9b3"><enum>(A)</enum><text>the size and demographics
of the population with malaria;</text>
</subparagraph><subparagraph id="id8e734c0f-fe9d-4d58-ad8a-f3e04e268ea7"><enum>(B)</enum><text>the needs of that
population;</text>
</subparagraph><subparagraph id="id650a73c7-dd56-4a22-8d90-0a92f66afbc6"><enum>(C)</enum><text>the country’s existing
infrastructure; and</text>
</subparagraph><subparagraph id="idd937fe66-5149-4e79-b1f5-5e479fcc6590"><enum>(D)</enum><text>the ability to closely
coordinate United States Government efforts with national malaria control plans
of partner
countries.</text>
</subparagraph></paragraph></subsection><after-quoted-block>.</after-quoted-block></quoted-block>
</paragraph></subsection></section><section id="idae190011-a37e-40e3-afc8-9cfc53789706"><enum>304.</enum><header>Malaria Response
Coordinator</header><text display-inline="no-display-inline">Section 304 of the
<short-title>United States Leadership Against HIV/AIDS,
Tuberculosis, and Malaria Act of 2003</short-title> (<external-xref legal-doc="usc" parsable-cite="usc/22/7634">22 U.S.C. 7634</external-xref>) is amended
to read as follows:</text>
<quoted-block changed="added" display-inline="no-display-inline" id="idd5f160dd-1186-48c5-8367-a37b7f9df0a4" reported-display-style="italic" style="OLC">
<section id="id21f46015-d7b6-462b-bf78-dd441944d099"><enum>304.</enum><header>Malaria Response
Coordinator</header>
<subsection id="ide886ff41-d7b2-4c08-a178-7859cf7a4e17"><enum>(a)</enum><header>In
general</header><text>There is established within the United States Agency for
International Development a Coordinator of United States Government Activities
to Combat Malaria Globally (referred to in this section as the <quote>Malaria
Coordinator</quote>), who shall be appointed by the President.</text>
</subsection><subsection id="idea90e05c-1e8e-4af9-8c4e-862b00c0c825"><enum>(b)</enum><header>Authorities</header><text>The
Malaria Coordinator, acting through nongovernmental organizations (including
faith-based and community-based organizations), partner country finance,
health, and other relevant ministries, and relevant executive branch agencies
as may be necessary and appropriate to carry out this section, is authorized
to—</text>
<paragraph id="idef83c90e-dc64-4983-99b0-3fba7b3766c5"><enum>(1)</enum><text>operate internationally
to carry out prevention, care, treatment, support, capacity development, and
other activities to reduce the prevalence, mortality, and incidence of
malaria;</text>
</paragraph><paragraph id="id945cb21f-fe32-447b-9f80-9c4645d0b2b5"><enum>(2)</enum><text>provide grants to, and
enter into contracts and cooperative agreements with, nongovernmental
organizations (including faith-based organizations) to carry out this section;
and</text>
</paragraph><paragraph id="id03070b2b-4c66-4d8d-8530-eb1b79844aa8"><enum>(3)</enum><text>transfer and allocate
executive branch agency funds that have been appropriated for the purposes
described in paragraphs (1) and (2).</text>
</paragraph></subsection><subsection id="id50d8c16c-454a-4db4-a3ec-72437c0d31da"><enum>(c)</enum><header>Duties</header>
<paragraph id="id910ea82e-6b68-48a9-aa02-b8a7cd371e4e"><enum>(1)</enum><header>In
general</header><text>The Malaria Coordinator has primary responsibility for
the oversight and coordination of all resources and international activities of
the United States Government relating to efforts to combat malaria.</text>
</paragraph><paragraph id="idcf64a24f-6edf-4ed5-a5ce-523840688dc8"><enum>(2)</enum><header>Specific
duties</header><text>The Malaria Coordinator shall—</text>
<subparagraph id="idbfbdfc07-c8e3-40be-9dba-e44d8fc1fcb4"><enum>(A)</enum><text>facilitate program and
policy coordination of antimalarial efforts among relevant executive branch
agencies and nongovernmental organizations by auditing, monitoring, and
evaluating such programs;</text>
</subparagraph><subparagraph id="id74926b49-1d48-4aa3-8e64-8b67a878afc8"><enum>(B)</enum><text>ensure that each relevant
executive branch agency undertakes antimalarial programs primarily in those
areas in which the agency has the greatest expertise, technical capability, and
potential for success;</text>
</subparagraph><subparagraph id="id771afbf4-fc00-43c4-bd33-6f898ff4a3d8"><enum>(C)</enum><text>coordinate relevant
executive branch agency activities in the field of malaria prevention and
treatment;</text>
</subparagraph><subparagraph id="id45a1af32-8250-490b-8596-a788d983a1f2"><enum>(D)</enum><text>coordinate planning,
implementation, and evaluation with the Global AIDS Coordinator in countries in
which both programs have a significant presence;</text>
</subparagraph><subparagraph id="id7e5fa6a6-54e0-4959-8a64-ed7bbc9ed0ac"><enum>(E)</enum><text>coordinate with national
governments, international agencies, civil society, and the private sector;
and</text>
</subparagraph><subparagraph id="id4e2ed363-1162-4aac-93be-ffb3add1cba5"><enum>(F)</enum><text>establish due diligence
criteria for all recipients of funds appropriated by the Federal Government for
malaria assistance.</text>
</subparagraph></paragraph></subsection><subsection id="id3cb6468c-72b7-4dc6-839a-9285cfec416a"><enum>(d)</enum><header>Assistance for the
World Health Organization</header><text>In carrying out this section, the
President may provide financial assistance to the Roll Back Malaria Partnership
of the World Health Organization to improve the capacity of countries with high
rates of malaria and other affected countries to implement comprehensive
malaria control programs.</text>
</subsection><subsection id="id7b48667e-06aa-4b3a-a378-91ac3eb7b4dd"><enum>(e)</enum><header>Coordination of
Assistance Efforts</header><text>In carrying out this section and in accordance
with section 104C of the Foreign Assistance Act of 1961 (<external-xref legal-doc="usc" parsable-cite="usc/22/2151b-4">22 U.S.C. 2151b–4</external-xref>),
the Malaria Coordinator shall coordinate the provision of assistance by working
with—</text>
<paragraph id="idebe38b6c-e1a6-448a-a071-3008a193f43d"><enum>(1)</enum><text>relevant executive branch
agencies, including—</text>
<subparagraph id="idcbb90d14-c4a6-4367-9508-b02f9d293b7c"><enum>(A)</enum><text>the Department of State
(including the Office of the Global AIDS Coordinator);</text>
</subparagraph><subparagraph id="id6d88e013-fe60-4ceb-ad1b-32bfe095c816"><enum>(B)</enum><text>the Department of Health
and Human Services;</text>
</subparagraph><subparagraph id="idde146be5-4761-41d7-bdd1-8a6209d178e3"><enum>(C)</enum><text>the Department of
Defense; and</text>
</subparagraph><subparagraph id="idc96ae457-774c-407c-8aed-8c9d76ed034d"><enum>(D)</enum><text>the Office of the United
States Trade Representative;</text>
</subparagraph></paragraph><paragraph id="iddbd72dd4-862d-40d6-829d-cc9d0c137e15"><enum>(2)</enum><text>relevant multilateral
institutions, including—</text>
<subparagraph id="idf8f1c433-afc4-4ebd-989c-5c3795081fc4"><enum>(A)</enum><text>the World Health
Organization;</text>
</subparagraph><subparagraph id="id61fd8820-4e02-4598-aa3a-0339ceaf73e9"><enum>(B)</enum><text>the United Nations
Children’s Fund;</text>
</subparagraph><subparagraph id="id28fd72fc-606d-4575-a0e2-abe13803ea17"><enum>(C)</enum><text>the United Nations
Development Programme;</text>
</subparagraph><subparagraph id="idebd869c3-7269-4d28-8320-b0e66bd5cfce"><enum>(D)</enum><text>the Global Fund;</text>
</subparagraph><subparagraph id="id086c195f-31c2-4734-aeba-66067ba8bf1a"><enum>(E)</enum><text>the World Bank;
and</text>
</subparagraph><subparagraph id="id84fd8622-0517-4577-b7b8-8679f13e8374"><enum>(F)</enum><text>the Roll Back Malaria
Partnership;</text>
</subparagraph></paragraph><paragraph id="id7440ef9e-3364-473f-8d1e-b01d8510ea81"><enum>(3)</enum><text>program delivery and
efforts to lift barriers that would impede effective and comprehensive malaria
control programs; and</text>
</paragraph><paragraph id="idc1eab887-f651-4724-979d-e3d6fff74766"><enum>(4)</enum><text>partner or recipient
country governments and national entities including universities and civil
society organizations (including faith- and community-based
organizations).</text>
</paragraph></subsection><subsection id="ID445f87a14c814fdabd3270e3dfa99722"><enum>(f)</enum><header>Research</header><text>To
carry out this section, the Malaria Coordinator, in accordance with section
104C of the Foreign Assistance Act of 1961 (<external-xref legal-doc="usc" parsable-cite="usc/22/1151d-4">22 U.S.C. 1151d–4</external-xref>), shall ensure
that operations and implementation research conducted under this Act will
closely complement the clinical and program research being undertaken by the
National Institutes of Health. The Centers for Disease Control and Prevention
should advise the Malaria Coordinator on priorities for operations and
implementation research and should be a key implementer of this
research.</text>
</subsection><subsection id="IDdfc3e6e317d8436398eede062c98751b"><enum>(g)</enum><header>Monitoring</header><text>To
ensure that adequate malaria controls are established and implemented, the
Centers for Disease Control and Prevention should advise the Malaria
Coordinator on monitoring, surveillance, and evaluation activities and be a key
implementer of such activities under this Act. Such activities shall
complement, rather than duplicate, the work of the World Health
Organization.</text>
</subsection><subsection id="ida39cd4d9-fccd-474a-a89b-1fcc8f029b73"><enum>(h)</enum><header>Annual report</header>
<paragraph id="idc1e9c4bc-f161-4e6e-92d8-b46bea0527d1"><enum>(1)</enum><header>Submission</header><text>Not
later than 1 year after the date of the enactment of the
<short-title>Tom Lantos and Henry J. Hyde United States
Global Leadership Against HIV/AIDS, Tuberculosis, and Malaria Reauthorization
Act of 2008</short-title>, and annually thereafter, the President shall submit
a report to the appropriate congressional committees that describes United
States assistance for the prevention, treatment, control, and elimination of
malaria.</text>
</paragraph><paragraph id="id6e93838b-e8e9-4ba6-b4f0-fb281d4f4c7d"><enum>(2)</enum><header>Contents</header><text>The
report required under paragraph (1) shall describe—</text>
<subparagraph id="idf6439ed4-9ad8-4167-a235-1d485f3a416e"><enum>(A)</enum><text>the countries and
activities to which malaria resources have been allocated;</text>
</subparagraph><subparagraph id="id0d39cecb-cd02-45c4-bab0-285eb0942d7d"><enum>(B)</enum><text>the number of people
reached through malaria assistance programs, including data on children and
pregnant women;</text>
</subparagraph><subparagraph id="idfc3378e6-b0de-4fbf-9c92-b2a9c6303713"><enum>(C)</enum><text>research efforts to
develop new tools to combat malaria, including drugs and vaccines;</text>
</subparagraph><subparagraph id="id0983b036-ea85-48a7-bf53-b365c493a4db"><enum>(D)</enum><text>the collaboration and
coordination of United States antimalarial efforts with the World Health
Organization, the Global Fund, the World Bank, other donor governments, major
private efforts, and relevant executive agencies;</text>
</subparagraph><subparagraph id="id2cb46757-c251-444e-8a33-a9cab69335c5"><enum>(E)</enum><text>the coordination of
United States antimalarial efforts with the national malarial strategies of
other donor or partner governments and major private initiatives;</text>
</subparagraph><subparagraph id="id5d0a2169-e3b2-49d2-a46d-754bddfed7ec"><enum>(F)</enum><text>the estimated impact of
United States assistance on childhood mortality and morbidity from
malaria;</text>
</subparagraph><subparagraph id="id5ba2688d-8a29-4ca5-951d-4a5cc971bcbf"><enum>(G)</enum><text>the coordination of
antimalarial efforts with broader health and development programs; and</text>
</subparagraph><subparagraph id="id27006351-fc4a-444e-8bb9-7c18e1081baa"><enum>(H)</enum><text>the constraints on
implementation of programs posed by health workforce shortages or capacities;
and</text>
</subparagraph><subparagraph id="id0d8e772f-b12c-4b9e-9db5-6f2692c66cae"><enum>(I)</enum><text>the number of personnel
trained as health workers and the training levels
achieved.</text>
</subparagraph></paragraph></subsection></section><after-quoted-block>.</after-quoted-block></quoted-block>
</section><section id="id71c8f709-3a16-4a30-b6f4-f330649cdde0"><enum>305.</enum><header>Amendment to
Immigration and Nationality Act</header><text display-inline="no-display-inline">Section 212(a)(1)(A)(i) of the Immigration
and Nationality Act (<external-xref legal-doc="usc" parsable-cite="usc/8/1182">8 U.S.C. 1182(a)(1)(A)(i)</external-xref>) is amended by striking <quote>,
which shall include infection with the etiologic agent for acquired immune
deficiency syndrome,</quote> and inserting a semicolon.</text>
</section><section id="id42a12d8f-a595-48e1-8e06-fe3b51fd54ae"><enum>306.</enum><header>Clerical
amendment</header><text display-inline="no-display-inline">Title III of the
<short-title>United States Leadership Against HIV/AIDS,
Tuberculosis, and Malaria Act of 2003</short-title> (<external-xref legal-doc="usc" parsable-cite="usc/22/7631">22 U.S.C. 7631 et seq.</external-xref>) is
amended by striking the heading for subtitle B and inserting the
following:</text>
<quoted-block changed="added" display-inline="no-display-inline" id="id879222cc-ab77-49b6-90c3-b5a2736fb84f" reported-display-style="italic" style="OLC">
<subtitle id="id835bba94-08b9-479e-a6c1-557341a9426a"><enum>B</enum><header>Assistance for women,
children, and
families</header>
</subtitle><after-quoted-block>.</after-quoted-block></quoted-block>
</section><section id="ide3a0e911-ba8e-4e98-9c2e-b83e5ffc33d1"><enum>307.</enum><header>Requirements</header><text display-inline="no-display-inline">Section 312(b) of the
<short-title>United States Leadership Against HIV/AIDS,
Tuberculosis, and Malaria Act of 2003</short-title> (<external-xref legal-doc="usc" parsable-cite="usc/22/7652">22 U.S.C. 7652(b)</external-xref>) is
amended by striking paragraphs (1), (2), and (3) and inserting the
following:</text>
<quoted-block changed="added" display-inline="no-display-inline" id="id45340047-f4d1-4682-99da-064176486cf0" reported-display-style="italic" style="OLC">
<paragraph id="id3e3590f6-836e-4191-91d8-8eb1c5665a58"><enum>(1)</enum><text>establish a target for
the prevention and treatment of mother-to-child transmission of HIV that, by
2013, will reach at least 80 percent of pregnant women in those countries most
affected by HIV/AIDS in which the United States has HIV/AIDS programs;</text>
</paragraph><paragraph id="iddfc32587-6704-471c-8ca4-bb35ce6e6d10"><enum>(2)</enum><text>establish a target that,
by 2013, the proportion of children receiving care and treatment under this Act
is proportionate to their numbers within the population of HIV infected
individuals in each country;</text>
</paragraph><paragraph id="idb4028ad2-f0ba-4ea7-88f5-97755d18b094"><enum>(3)</enum><text>integrate care and
treatment with prevention of mother-to-child transmission of HIV programs to
improve outcomes for HIV-affected women and families as soon as is feasible and
support strategies that promote successful follow-up and continuity of care of
mother and child;</text>
</paragraph><paragraph id="id0853b407-79fe-47f1-99bd-3b67c267a38c"><enum>(4)</enum><text>expand programs designed
to care for children orphaned by, affected by, or vulnerable to
HIV/AIDS;</text>
</paragraph><paragraph id="idcb8ff443-b94f-43b3-90c5-5ab9ccaaa245"><enum>(5)</enum><text>ensure that women in
prevention of mother-to-child transmission of HIV programs are provided with,
or referred to, appropriate maternal and child services; and</text>
</paragraph><paragraph id="id9a4c80f8-e1eb-48ee-9ae0-75c4e7ba6b06"><enum>(6)</enum><text>develop a timeline for
expanding access to more effective regimes to prevent mother-to-child
transmission of HIV, consistent with the national policies of countries in
which programs are administered under this Act and the goal of achieving
universal use of such regimes as soon as
possible.</text>
</paragraph><after-quoted-block>.</after-quoted-block></quoted-block>
</section><section id="id1fbcbc79-56b8-4aff-ba00-87004afad1df"><enum>308.</enum><header>Annual report on
prevention of mother-to-child transmission of HIV</header><text display-inline="no-display-inline">Section 313(a) of the
<short-title>United States Leadership Against HIV/AIDS,
Tuberculosis, and Malaria Act of 2003</short-title> (<external-xref legal-doc="usc" parsable-cite="usc/22/7653">22 U.S.C. 7653(a)</external-xref>) is
amended by striking <quote>5 years</quote> and inserting <quote>10
years</quote>.</text>
</section><section id="id13F0D5F6289349EDAFE782118DBDB2CC"><enum>309.</enum><header>Prevention of
mother-to-child transmission expert panel</header><text display-inline="no-display-inline">Section 312 of the United States Leadership
Against HIV/AIDS, Tuberculosis, and Malaria Act of 2003 (<external-xref legal-doc="usc" parsable-cite="usc/22/7652">22 U.S.C. 7652</external-xref>) is
amended by adding at the end the following:</text>
<quoted-block changed="added" display-inline="no-display-inline" id="id34A39DBCA50F4FADA903FDBB62429C22" reported-display-style="italic" style="OLC">
<subsection id="ID3b49448b532c4019b4110072a95a63ca"><enum>(c)</enum><header>Prevention of
mother-to-child transmission expert panel</header>
<paragraph id="IDac8c5faefb654a179c3d7712cd5492ac"><enum>(1)</enum><header>Establishment</header><text>The
Global AIDS Coordinator shall establish a panel of experts to be known as the
Prevention of Mother-to-Child Transmission Panel (referred to in this
subsection as the <quote>Panel</quote>) to—</text>
<subparagraph id="IDdcd1677aa9654357a49fcc3bc76ef15a"><enum>(A)</enum><text>provide an objective
review of activities to prevent mother-to-child transmission of HIV; and</text>
</subparagraph><subparagraph id="ID264b9f627d634ece9bc844ec3c0cd9fb"><enum>(B)</enum><text>provide recommendations
to the Global AIDS Coordinator and to the appropriate congressional committees
for scale-up of mother-to-child transmission prevention services under this Act
in order to achieve the target established in subsection (b)(1).</text>
</subparagraph></paragraph><paragraph id="ID008e15bfe86846a885ef8ee9848a9285"><enum>(2)</enum><header>Membership</header><text>The
Panel shall be convened and chaired by the Global AIDS Coordinator, who shall
serve as a nonvoting member. The Panel shall consist of not more than 15
members (excluding the Global AIDS Coordinator), to be appointed by the Global
AIDS Coordinator not later than 1 year after the date of the enactment of this
Act, including—</text>
<subparagraph id="ID7d5a9d6048d14c5c9dcfa72451442c17"><enum>(A)</enum><text>2 members from the
Department of Health and Human Services with expertise relating to the
prevention of mother-to-child transmission activities;</text>
</subparagraph><subparagraph id="ID492b27666d6b4c278ea346153a9a0299"><enum>(B)</enum><text>2 members from the United
States Agency for International Development with expertise relating to the
prevention of mother-to-child transmission activities;</text>
</subparagraph><subparagraph id="IDe9ba9fee4e2d4b47976676aecd0535e6"><enum>(C)</enum><text>2 representatives from
among health ministers of national governments of foreign countries in which
programs under this Act are administered;</text>
</subparagraph><subparagraph id="ID72e9f3db04ce420d80fe2f79dda86a36"><enum>(D)</enum><text>3 members representing
organizations implementing prevention of mother-to-child transmission
activities under this Act;</text>
</subparagraph><subparagraph id="IDef22bff336a7491cabd360279f658ea7"><enum>(E)</enum><text>2 health care researchers
with expertise relating to global HIV/AIDS activities; and</text>
</subparagraph><subparagraph id="ID425703a18d684fe59b2c7d73409a765b"><enum>(F)</enum><text>representatives from
among patient advocate groups, health care professionals, persons living with
HIV/AIDS, and non-governmental organizations with expertise relating to the
prevention of mother-to-child transmission activities, giving priority to
individuals in foreign countries in which programs under this Act are
administered.</text>
</subparagraph></paragraph><paragraph id="ID58a15aa6c37b4254985c4dcf0fa1d8d8"><enum>(3)</enum><header>Duties of
panel</header><text>The Panel shall—</text>
<subparagraph id="IDf95f7307a9f54dffa4e58fd6e8d43020"><enum>(A)</enum><text>assess the effectiveness
of current activities in reaching the target described in subsection
(b)(1);</text>
</subparagraph><subparagraph id="IDb1d239a7a53543c69a0be0b270004d8f"><enum>(B)</enum><text>review scientific
evidence related to the provision of mother-to-child transmission prevention
services, including programmatic data and data from clinical trials;</text>
</subparagraph><subparagraph id="IDa9accfa3707341c291212396dd04f62f"><enum>(C)</enum><text>review and assess ways in
which the Office of the United States Global AIDS Coordinator collaborates with
international and multilateral entities on efforts to prevent mother-to-child
transmission of HIV in affected countries;</text>
</subparagraph><subparagraph id="IDd942dc52cd5b4b0c96d98a7be36b75ee"><enum>(D)</enum><text>identify barriers and
challenges to increasing access to mother-to-child transmission prevention
services and evaluate potential mechanisms to alleviate those barriers and
challenges;</text>
</subparagraph><subparagraph id="IDbdba4870e8ea4221abcb96388642909c"><enum>(E)</enum><text>identify the extent to
which stigma has hindered pregnant women from obtaining HIV counseling and
testing or returning for results, and provide recommendations to address such
stigma and its effects;</text>
</subparagraph><subparagraph id="ID6e8acc0506464d2494f58bb76a9532f4"><enum>(F)</enum><text>identify opportunities to
improve linkages between mother-to-child transmission prevention services and
care and treatment programs; and</text>
</subparagraph><subparagraph id="IDf825c3c0f5174141ae1d1341f1f2aa92"><enum>(G)</enum><text>recommend specific
activities to facilitate reaching the target described in subsection
(b)(1).</text>
</subparagraph></paragraph><paragraph id="IDb3d7908d3efa4cc98e1730d77d1306af"><enum>(4)</enum><header>Report</header>
<subparagraph id="IDd0d8b52ba92f48aab3ff4ac4ff3c97ee"><enum>(A)</enum><header>In
general</header><text>Not later than 1 year after the date on which the Panel
is first convened, the Panel shall submit a report containing a detailed
statement of the recommendations, findings, and conclusions of the Panel to the
appropriate congressional committees.</text>
</subparagraph><subparagraph id="ID7dd09686d5834a3cbfc8ac91c7ff8984"><enum>(B)</enum><header>Availability</header><text>The
report submitted under subparagraph (A) shall be made available to the
public.</text>
</subparagraph><subparagraph id="IDfd4c4c9760e14d459375309f42481002"><enum>(C)</enum><header>Consideration by
coordinator</header><text>The Coordinator shall—</text>
<clause id="id1ECFE9651AA14D0E9AC8BA04B0EA76C8"><enum>(i)</enum><text>consider any
recommendations contained in the report submitted under subparagraph (A);
and</text>
</clause><clause id="idB4E8A2A7E01F4CBD94EFC8A3079BD651"><enum>(ii)</enum><text>include in the annual
report required under section 104A(f) of the Foreign Assistance Act of 1961 a
description of the activities conducted in response to the recommendations made
by the Panel and an explanation of any recommendations not implemented at the
time of the report.</text>
</clause></subparagraph></paragraph><paragraph id="IDc9f366850fa840e5a7cf93422ad7fcec"><enum>(5)</enum><header>Authorization of
appropriations</header><text>There are authorized to be appropriated to the
Panel such sums as may be necessary for each of the fiscal years 2009 through
2011 to carry out this section.</text>
</paragraph><paragraph id="IDd7e61d574b36489388da7e854bd4c124"><enum>(6)</enum><header>Termination</header><text>The
Panel shall terminate on the date that is 60 days after the date on which the
Panel submits the report to the appropriate congressional committees under
paragraph
(4).</text>
</paragraph></subsection><after-quoted-block>.</after-quoted-block></quoted-block>
</section></subtitle><enum>IV</enum><header>Funding
allocations</header>
<section id="id1c3a7f27-de47-4342-95a8-18dc2ed45a5a"><enum>401.</enum><header>Authorization of
appropriations</header>
<subsection id="id73E608340737481EAB7723B42AF97953"><enum>(a)</enum><header>In
general</header><text display-inline="yes-display-inline">Section 401(a) of the
<short-title>United States Leadership Against HIV/AIDS,
Tuberculosis, and Malaria Act of 2003</short-title> (<external-xref legal-doc="usc" parsable-cite="usc/22/7671">22 U.S.C. 7671(a)</external-xref>) is
amended by striking <quote>$3,000,000,000 for each of the fiscal years 2004
through 2008</quote> and inserting <quote>$48,000,000,000 for the 5-year period
beginning on October 1, 2008</quote>.</text>
</subsection><subsection id="IDd7119ba87e4d46dbb0daf89b17952770"><enum>(b)</enum><header>Sense of
Congress</header><text>It is the sense of the Congress that the appropriations
authorized under section 401(a) of the United States Leadership Against
HIV/AIDS, Tuberculosis, and Malaria Act of 2003, as amended by subsection (a),
should be allocated among fiscal years 2009 through 2013 in a manner that
allows for the appropriations to be gradually increased in a manner that is
consistent with program requirements, absorptive capacity, and priorities set
forth in such Act, as amended by this Act.</text>
</subsection></section><section id="id404f103a-df1b-4341-84ce-0ee4c3f06448"><enum>402.</enum><header>Sense of
Congress</header><text display-inline="no-display-inline">Section 402(b) of the
<short-title>United States Leadership Against HIV/AIDS,
Tuberculosis, and Malaria Act of 2003</short-title> (<external-xref legal-doc="usc" parsable-cite="usc/22/7672">22 U.S.C. 7672(b)</external-xref>) is
amended by striking <quote>an effective distribution of such amounts would
be</quote> and all that follows through <quote>10 percent of such
amounts</quote> and inserting <quote>10 percent should be used</quote>.</text>
</section><section id="id7cba48d6-7aa9-48c6-9c4b-77fb0b1b4994"><enum>403.</enum><header>Allocation of
funds</header><text display-inline="no-display-inline">Section 403 of the
<short-title>United States Leadership Against HIV/AIDS,
Tuberculosis, and Malaria Act of 2003</short-title> (<external-xref legal-doc="usc" parsable-cite="usc/22/7673">22 U.S.C. 7673</external-xref>) is
amended—</text>
<paragraph id="idecb04780-50f1-4c76-bffa-7b18d5a4b426"><enum>(1)</enum><text display-inline="yes-display-inline">by amending subsection (a) to read as
follows:</text>
<quoted-block changed="added" display-inline="no-display-inline" id="idf8418463-3361-43bf-8915-79ec08325fab" reported-display-style="italic" style="OLC">
<subsection id="idb9f888c4-8cf9-4c92-b07a-e491de8d01d5"><enum>(a)</enum><header>Balanced funding
requirement</header>
<paragraph id="id5d0c6ea3-3150-495a-a6b2-6bb539c23cec"><enum>(1)</enum><header>In
general</header><text>The Global AIDS Coordinator shall—</text>
<subparagraph id="id45ad5a76-6cc3-45cc-9550-e60a6dc54e0b"><enum>(A)</enum><text>provide balanced funding
for prevention activities for sexual transmission of HIV/AIDS; and</text>
</subparagraph><subparagraph id="id8b771921-6957-496e-8e1b-8b678e915298"><enum>(B)</enum><text>ensure that activities
promoting abstinence, delay of sexual debut, monogamy, fidelity, and partner
reduction are implemented and funded in a meaningful and equitable way in the
strategy for each host country based on objective epidemiological evidence as
to the source of infections and in consultation with the government of each
host county involved in HIV/AIDS prevention activities.</text>
</subparagraph></paragraph><paragraph id="id5193cb57-fded-4ee8-9313-70f853cf121f"><enum>(2)</enum><header>Prevention
strategy</header>
<subparagraph id="id5e498db3-9aab-463f-914d-4bca40edaf79"><enum>(A)</enum><header>Establishment</header><text>In
carrying out paragraph (1), the Global AIDS Coordinator shall establish an HIV
sexual transmission prevention strategy governing the expenditure of funds
authorized under this Act to prevent the sexual transmission of HIV in any host
country with a generalized epidemic.</text>
</subparagraph><subparagraph id="id4c02f4a5-90c7-47bf-ab43-dc31f948c78f"><enum>(B)</enum><header>Report</header><text>In
each host country described in subparagraph (A), if the strategy established
under subparagraph (A) provides less than 50 percent of the funds described in
subparagraph (A) for activities promoting abstinence, delay of sexual debut,
monogamy, fidelity, and partner reduction, the Global AIDS Coordinator shall,
not later than 30 days after the issuance of this strategy, report to the
appropriate congressional committees on the justification for this
decision.</text>
</subparagraph></paragraph><paragraph id="ida695d37e-f45c-457d-82dc-6d21f1d4d32a"><enum>(3)</enum><header>Exclusion</header><text>Programs
and activities that implement or purchase new prevention technologies or
modalities, such as medical male circumcision, public education about risks to
acquire HIV infection from blood exposures, promoting universal precautions,
investigating suspected nosocomial infections, pre-exposure pharmaceutical
prophylaxis to prevent transmission of HIV, or microbicides and programs and
activities that provide counseling and testing for HIV or prevent
mother-to-child prevention of HIV, shall not be included in determining
compliance with paragraph (2).</text>
</paragraph><paragraph commented="no" display-inline="no-display-inline" id="id507c546c-c169-4eb1-88e1-10f9f116de2c"><enum>(4)</enum><header>Report</header><text>Not
later than 1 year after the date of the enactment of the
<short-title>Tom Lantos and Henry J. Hyde United States
Global Leadership Against HIV/AIDS, Tuberculosis, and Malaria Reauthorization
Act of 2008</short-title>, and annually thereafter as part of the annual report
required under section 104A(e) of the Foreign Assistance Act of 1961 (22 U.S.C.
2151b–2(e)), the President shall—</text>
<subparagraph commented="no" display-inline="no-display-inline" id="id1c277b63-930d-47dd-b612-c8b5e0f573c9"><enum>(A)</enum><text>submit a report on the
implementation of paragraph (2) for the most recently concluded fiscal year to
the appropriate congressional committees; and</text>
</subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="ide11d2c25-61ff-4320-b358-5769d68411e6"><enum>(B)</enum><text>make the report described
in subparagraph (A) available to the
public.</text>
</subparagraph></paragraph></subsection><after-quoted-block>;</after-quoted-block></quoted-block>
</paragraph><paragraph id="id19429d04-9b53-4d97-8563-725cdd303222"><enum>(2)</enum><text display-inline="yes-display-inline">in subsection (b)—</text>
<subparagraph id="id7fe9aa5a-6c1e-4e8a-be29-48a984fa8243"><enum>(A)</enum><text display-inline="yes-display-inline">by striking <quote>fiscal years 2006
through 2008</quote> and inserting <quote>fiscal years 2009 through
2013</quote>; and</text>
</subparagraph><subparagraph id="id46491cac-9bf7-4039-814d-ce0a230e2547"><enum>(B)</enum><text>by striking
<quote>vulnerable children affected by</quote> and inserting <quote>other
children affected by, or vulnerable to,</quote>; and</text>
</subparagraph></paragraph><paragraph id="ID7ad115754a91448293714bb6a6aec996"><enum>(3)</enum><text>by adding at the end the
following:</text>
<quoted-block changed="added" display-inline="no-display-inline" id="id21F4FCFD0F994FBA8B1339F7D1E1E5A7" reported-display-style="italic" style="OLC">
<subsection id="idA0279124A87B4F7BA1A45094A57D312A"><enum>(c)</enum><header>Funding
allocation</header><text>For each of the fiscal years 2009 through 2013, more
than half of the amounts appropriated for bilateral global HIV/AIDS assistance
pursuant to section 401 shall be expended for—</text>
<paragraph id="idEF50985CE26A4FF9B757D08F41DAB190"><enum>(1)</enum><text>antiretroviral treatment
for HIV/AIDS;</text>
</paragraph><paragraph id="idEDF2D1BCDC05476BAE555A78C24401E5"><enum>(2)</enum><text>clinical monitoring of
HIV-seropositive people not in need of antiretroviral treatment;</text>
</paragraph><paragraph id="idBD74430727004B25B95CC7D3A7CF14E9"><enum>(3)</enum><text>care for associated
opportunistic infections;</text>
</paragraph><paragraph id="id943D4F4A7688433C87E87349647DECB6"><enum>(4)</enum><text>nutrition and food
support for people living with HIV/AIDS; and</text>
</paragraph><paragraph id="id2A7ADD5514484DEF903B1523D0D363EA"><enum>(5)</enum><text>other essential
HIV/AIDS-related medical care for people living with HIV/AIDS.</text>
</paragraph></subsection><subsection id="IDfafc73a46ec94261b9b856c889e137f9"><enum>(d)</enum><header>Treatment, prevention,
and care goals</header><text>For each of the fiscal years 2009 through
2013—</text>
<paragraph id="idD9B7EF28621F45E79779EBEB906EE16B"><enum>(1)</enum><text>the treatment goal under
section 402(a)(3) shall be increased above 2,000,000 by at least the percentage
increase in the amount appropriated for bilateral global HIV/AIDS assistance
for such fiscal year compared with fiscal year 2008;</text>
</paragraph><paragraph id="idF2CD0F6C78CE4F7E960577DFF15605F3"><enum>(2)</enum><text>any increase in the
treatment goal under section 402(a)(3) above the percentage increase in the
amount appropriated for bilateral global HIV/AIDS assistance for such fiscal
year compared with fiscal year 2008 shall be based on long-term requirements,
epidemiological evidence, the share of treatment needs being met by partner
governments and other sources of treatment funding, and other appropriate
factors;</text>
</paragraph><paragraph id="id91FAEE6F2B9540A78803F495773A2284"><enum>(3)</enum><text>the treatment goal under
section 402(a)(3) shall be increased above the number calculated under
paragraph (1) by the same percentage that the average United States Government
cost per patient of providing treatment in countries receiving bilateral
HIV/AIDS assistance has decreased compared with fiscal year 2008; and</text>
</paragraph><paragraph id="ID843a515a695749fa8019c8839d2a6b66"><enum>(4)</enum><text>the prevention and care
goals established in clauses (i) and (iv) of section 104A(b)(1)(A) of the
Foreign Assistance Act of 1961 (<external-xref legal-doc="usc" parsable-cite="usc/22/2151b-2">22 U.S.C. 2151b–2(b)(1)(A)</external-xref>) shall be increased
consistent with epidemiological evidence and available
resources.</text>
</paragraph></subsection><after-quoted-block>.</after-quoted-block></quoted-block>
</paragraph></section><enum>V</enum><header>Miscellaneous</header>
<section id="IDbd6261f9b652487984066c4464469534"><enum>501.</enum><header>Machine readable visa
fees</header>
<subsection id="ID71325b4fd99c4acb9d04563b1464903a"><enum>(a)</enum><header>Fee
increase</header><text>Notwithstanding any other provision of law—</text>
<paragraph id="ID7e28bda7a38c4a489e26e79ca945b060"><enum>(1)</enum><text>not later than October 1,
2010, the Secretary of State shall increase by $1 the fee or surcharge
authorized under section 140(a) of the Foreign Relations Authorization Act,
Fiscal Years 1994 and 1995 (<external-xref legal-doc="public-law" parsable-cite="pl/103/236">Public Law 103–236</external-xref>; <external-xref legal-doc="usc" parsable-cite="usc/8/1351">8 U.S.C. 1351</external-xref> note) for
processing machine readable nonimmigrant visas and machine readable combined
border crossing identification cards and nonimmigrant visas; and</text>
</paragraph><paragraph id="IDe13a154ccfef458b8f801df1bd9611a1"><enum>(2)</enum><text>not later than October 1,
2013, the Secretary shall increase the fee or surcharge described in paragraph
(1) by an additional $1.</text>
</paragraph></subsection><subsection id="ID4fa8a9fba8a04ad28262e3ada3b9af60"><enum>(b)</enum><header>Deposit of
amounts</header><text>Notwithstanding section 140(a)(2) of the Foreign
Relations Authorization Act, Fiscal Years 1994 and 1995 (<external-xref legal-doc="public-law" parsable-cite="pl/103/236">Public Law 103–236</external-xref>; 8
U.S.C. 1351 note), fees collected under the authority of subsection (a) shall
be deposited in the Treasury.</text>
</subsection></section><enum>VI</enum><header>Emergency plan for
Indian safety and health</header>
<section id="idF9204ACCF646462786A40BC8295929B8"><enum>601.</enum><header>Emergency plan for
Indian safety and health</header>
<subsection id="id5A2D104626994792BE8043F180AA2024"><enum>(a)</enum><header>Establishment of
Fund</header><text>There is established in the Treasury of the United States a
fund, to be known as the <quote>Emergency Fund for Indian Safety and
Health</quote> (referred to in this section as the <quote>Fund</quote>),
consisting of such amounts as are appropriated to the Fund under subsection
(b).</text>
</subsection><subsection id="ID75847D4BD6B24B8E83CBB81F88EF90BB"><enum>(b)</enum><header>Transfers to
Fund</header>
<paragraph id="id839E026D11BE487E8A80A275D02CE4CF"><enum>(1)</enum><header>In
general</header><text>There is authorized to be appropriated to the Fund, out
of funds of the Treasury not otherwise appropriated, $2,000,000,000 for the
5-year period beginning on October 1, 2008.</text>
</paragraph><paragraph id="ID5dece4d1f72f4d308b8caeb917c55e40"><enum>(2)</enum><header>Availability of
amounts</header><text>Amounts deposited in the Fund under this section
shall—</text>
<subparagraph id="idAFCCF49FEC5041AEBEE38F809F04B623"><enum>(A)</enum><text>be made available without
further appropriation;</text>
</subparagraph><subparagraph id="idE4F3F4AA820B4CB5A530D4AC4B30FA59"><enum>(B)</enum><text>be in addition to amounts
made available under any other provision of law; and</text>
</subparagraph><subparagraph id="IDa121647387fd4fe3a359100523878cd2"><enum>(C)</enum><text>remain available until
expended.</text>
</subparagraph></paragraph></subsection><subsection id="id4241CE8758ED4B60AC309BC3C832C193"><enum>(c)</enum><header>Expenditures from
Fund</header><text>On request by the Attorney General, the Secretary of the
Interior, or the Secretary of Health and Human Services, the Secretary of the
Treasury shall transfer from the Fund to the Attorney General, the Secretary of
the Interior, or the Secretary of Health and Human Services, as appropriate,
such amounts as the Attorney General, the Secretary of the Interior, or the
Secretary of Health and Human Services determines to be necessary to carry out
the emergency plan under subsection (f).</text>
</subsection><subsection id="ID990781DF86FA4B5A8ADACB8C3C4C49B3"><enum>(d)</enum><header>Transfers of
amounts</header>
<paragraph id="IDEA15210E59234B4AB0176880E4E2B3F6"><enum>(1)</enum><header>In
general</header><text>The amounts required to be transferred to the Fund under
this section shall be transferred at least monthly from the general fund of the
Treasury to the Fund on the basis of estimates made by the Secretary of the
Treasury.</text>
</paragraph><paragraph commented="no" display-inline="no-display-inline" id="IDCF3824F211E742E7A61FAAF06623B01E"><enum>(2)</enum><header>Adjustments</header><text>Proper
adjustment shall be made in amounts subsequently transferred to the extent
prior estimates were in excess of or less than the amounts required to be
transferred.</text>
</paragraph></subsection><subsection commented="no" display-inline="no-display-inline" id="id08CB9AB4D7A8410B99E7D8BF70A14665"><enum>(e)</enum><header>Remaining
amounts</header><text>Any amounts remaining in the Fund on September 30 of an
applicable fiscal year may be used by the Attorney General, the Secretary of
the Interior, or the Secretary of Health and Human Services to carry out the
emergency plan under subsection (f) for any subsequent fiscal year.</text>
</subsection><subsection id="id4E11D1311D7A49AFB8C67635F58A4EF1"><enum>(f)</enum><header>Emergency
plan</header><text>Not later than 1 year after the date of enactment of this
Act, the Attorney General, the Secretary of the Interior, and the Secretary of
Health and Human Services, in consultation with Indian tribes (as defined in
section 4 of the <act-name parsable-cite="ISDA">Indian Self-Determination and
Education Assistance Act</act-name> (<external-xref legal-doc="usc" parsable-cite="usc/25/450b">25 U.S.C. 450b</external-xref>)), shall jointly establish
an emergency plan that addresses law enforcement, water, and health care needs
of Indian tribes under which, for each of fiscal years 2010 through 2019, of
amounts in the Fund—</text>
<paragraph id="id584A5DCD9460414895D9524032E272D7"><enum>(1)</enum><text>the Attorney General
shall use—</text>
<subparagraph id="id370FBB9F32434B8DB7A749CF2F11EDEE"><enum>(A)</enum><text>18.5 percent for the
construction, rehabilitation, and replacement of Federal Indian detention
facilities;</text>
</subparagraph><subparagraph id="ID30ef4b8440b94360bf2eaa8536e5a1e8"><enum>(B)</enum><text>1.5 percent to
investigate and prosecute crimes in Indian country (as defined in section 1151
of title 18, United States Code);</text>
</subparagraph><subparagraph id="ID77ab4cb526274b38b5e7318429ed2d82"><enum>(C)</enum><text>1.5 percent for use by
the Office of Justice Programs for Indian and Alaska Native programs;
and</text>
</subparagraph><subparagraph id="ID9c39cc5c883a41638cae3e14b7932a47"><enum>(D)</enum><text>0.5 percent to provide
assistance to—</text>
<clause id="id2FFD09E3039D4F4DB81FEF7B16DE9FB9"><enum>(i)</enum><text>parties to
cross-deputization or other cooperative agreements between State or local
governments and Indian tribes (as defined in section 102 of the Federally
Recognized Indian Tribe List Act of 1994 (<external-xref legal-doc="usc" parsable-cite="usc/25/479a">25 U.S.C. 479a</external-xref>)) carrying out law
enforcement activities in Indian country; and</text>
</clause><clause id="IDdd399ab3050e47d0aa93864c7f66992a"><enum>(ii)</enum><text>the State of Alaska
(including political subdivisions of that State) for carrying out the Village
Public Safety Officer Program and law enforcement activities on Alaska Native
land (as defined in section 3 of <external-xref legal-doc="public-law" parsable-cite="pl/103/399">Public Law 103–399</external-xref> (<external-xref legal-doc="usc" parsable-cite="usc/25/3902">25 U.S.C. 3902</external-xref>));</text>
</clause></subparagraph></paragraph><paragraph id="ID0093d3893aba4445872c16190a6bc905"><enum>(2)</enum><text>the Secretary of the
Interior shall—</text>
<subparagraph id="idB0145B3661B14ACEA9ED4ADFB6954791"><enum>(A)</enum><text>deposit 15.5 percent in
the public safety and justice account of the Bureau of Indian Affairs for use
by the Office of Justice Services of the Bureau in providing law enforcement or
detention services, directly or through contracts or compacts with Indian
tribes under the Indian Self-Determination and Education Assistance Act (25
U.S.C. 450 et seq.); and</text>
</subparagraph><subparagraph id="ID6fc335c87fff497fa7af2fb3739515e5"><enum>(B)</enum><text>use 50 percent to
implement requirements of Indian water settlement agreements that are approved
by Congress (or the legislation to implement such an agreement) under which the
United States shall plan, design, rehabilitate, or construct, or provide
financial assistance for the planning, design, rehabilitation, or construction
of, water supply or delivery infrastructure that will serve an Indian tribe (as
defined in section 4 of the <act-name parsable-cite="ISDA">Indian
Self-Determination and Education Assistance Act</act-name> (<external-xref legal-doc="usc" parsable-cite="usc/25/450b">25 U.S.C. 450b</external-xref>));
and</text>
</subparagraph></paragraph><paragraph id="id8FD44437612F4C51B73D10275C348D10"><enum>(3)</enum><text>the Secretary of Health
and Human Services, acting through the Director of the Indian Health Service,
shall use 12.5 percent to provide, directly or through contracts or compacts
with Indian tribes under the Indian Self-Determination and Education Assistance
Act (<external-xref legal-doc="usc" parsable-cite="usc/25/450">25 U.S.C. 450 et seq.</external-xref>)—</text>
<subparagraph id="idB516D5CD27A44FCA906FC57D031299BD"><enum>(A)</enum><text>contract health
services;</text>
</subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="id868CDF7DA42A4B0E989C799601A7E362"><enum>(B)</enum><text display-inline="yes-display-inline">construction, rehabilitation, and
replacement of Indian health facilities; and</text>
</subparagraph><subparagraph id="id7F8B718219C946B69B682D738D854FC8"><enum>(C)</enum><text>domestic and community
sanitation facilities serving members of Indian tribes (as defined in section 4
of the <act-name parsable-cite="ISDA">Indian Self-Determination and Education
Assistance Act</act-name> (<external-xref legal-doc="usc" parsable-cite="usc/25/450b">25 U.S.C. 450b</external-xref>)) pursuant to section 7 of the Act of
August 5, 1954 (<external-xref legal-doc="usc" parsable-cite="usc/42/2004a">42 U.S.C. 2004a</external-xref>).</text>
</subparagraph></paragraph></subsection></section>
Secretary