110 HR 5501 EH: Tom Lantos and Henry J. Hyde
U.S. House of Representatives
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1.Short title and 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 and table of contents.
Sec. 2. Findings.
Sec. 3. Definitions.
Sec. 4. Purpose.
Title I—Policy planning and coordination
Sec. 101. Development of a comprehensive, five-year, global
strategy.
Sec. 102. HIV/AIDS Response Coordinator.
Title II—Support for multilateral funds, programs, and
public-private partnerships
Sec. 201. Sense of Congress on public-private
partnerships.
Sec. 202. Participation in the Global Fund to Fight AIDS,
Tuberculosis and Malaria.
Sec. 203. Voluntary contributions to international vaccine
funds.
Sec. 204. Program to facilitate availability of microbicides to
prevent transmission of HIV and other diseases.
Sec. 205. Plan to combat HIV/AIDS, tuberculosis, and malaria
by strengthening health policies and health systems of host
countries.
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. Health care partnerships to combat
HIV/AIDS.
Subtitle B—Assistance for women, children, and
families
Sec. 311. Policy and requirements.
Sec. 312. Annual reports on prevention of mother-to-child
transmission of the HIV infection.
Sec. 313. Strategy to prevent HIV infections among women and
youth.
Sec. 314. Clerical amendment.
Title IV—Authorization of appropriations
Sec. 401. Authorization of appropriations.
Sec. 402. Sense of Congress.
Sec. 403. Allocation of funds.
Sec. 404. Prohibition on taxation by foreign
governments.
Title V—Sustainability and strengthening of health care
systems
Sec. 501. Sustainability and strengthening of health care
systems.
Sec. 502. Clerical amendment.
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)The HIV/AIDS pandemic continues to pose a
major threat to the health of the global community, from the most
severely-affected regions of sub-Saharan Africa and the Caribbean, to the
emerging epidemics of Eastern Europe, Central Asia, South and Southeast Asia,
and Latin America.
(30)According to
UNAIDS’ 2007 global estimates, there are 33.2 million individuals with HIV/AIDS
worldwide, including 2.5 million people newly-infected with HIV. Of those
infected with HIV, 2.5 million are children under 15 who also account for
460,000 of the newly-infected individuals.
(31)Sub-Saharan Africa continues to be the
region most affected by the HIV/AIDS pandemic. More than 68 percent of adults
and nearly 90 percent of children with HIV/AIDS live in sub-Saharan Africa, and
more than 76 percent of AIDS deaths in 2007 occurred in sub-Saharan
Africa.
(32)Although sub-Saharan Africa carries the
heaviest disease burden of HIV/AIDS, the HIV/AIDS pandemic continues to affect
virtually every world region. While prevalence rates are relatively low in
Eastern Europe, Central Asia, South and Southeast Asia, and Latin America,
without effective prevention strategies, HIV prevalence rates could rise
quickly in these regions.
(33)By world region, according to UNAIDS’ 2007
global estimates—
(A)in sub-Saharan Africa, there were 22.5
million adults and children infected with HIV, up from 20.9 million in 2001,
with 1.7 million new HIV infections, a 5 percent prevalence rate, and 1.6
million deaths;
(B)in South and
Southeast Asia, there were 4 million adults and children infected with HIV, up
from 3.5 million in 2001, with 340,000 new HIV infections, a 0.3 percent
prevalence rate, and 270,000 deaths;
(C)in East Asia,
there were 800,000 adults and children infected with HIV, up from 420,000 in
2001, with 92,000 new HIV infections, a 0.1 percent prevalence rate, and 32,000
deaths;
(D)in Eastern and Central Europe, there were
1.6 million adults and children infected with HIV, up from 630,000 in 2001,
with 150,000 new HIV infections, a 0.9 percent prevalence rate, and 55,000
deaths; and
(E)in the Caribbean,
there were 230,000 adults and children infected with HIV, up from 190,000 in
2001, with 17,000 new HIV infections, a 1 percent prevalence rate, and 11,000
deaths.
(34)Tuberculosis is
the number one killer of individuals with HIV/AIDS and is responsible for up to
one-half of HIV/AIDS deaths in Africa.
(35)The wide extent of drug resistant
tuberculosis, including both multi-drug resistant tuberculosis (MDR–TB) and
extensively drug resistant tuberculosis (XDR–TB), driven by the HIV/AIDS
pandemic in sub-Saharan Africa, has hampered both HIV/AIDS and tuberculosis
treatment services. The World Health Organization (WHO) has declared the
prevalence of tuberculosis to be at emergency levels in sub-Saharan
Africa.
(36)Forty percent of the world’s population,
mostly poor, live in malarial zones, and malaria, which is highly preventable,
kills more than 1 million individuals worldwide each year. Ninety percent of
malaria’s victims are in sub-Saharan Africa and 70 percent of malaria’s victims
are children under the age of 5. Additionally, hunger and malnutrition kill
another 6 million individuals worldwide each year.
(37)Assistance to
combat HIV/AIDS must address the nutritional factors associated with the
disease in order to be effective and sustainable. The World Food Program
estimates that 6.4 million individuals affected by HIV will need nutritional
support by 2008.
(38)Women and girls
continue to be vulnerable to HIV, in large part, due to gender-based cultural
norms that leave many women and girls powerless to negotiate social
relationships.
(39)Women make up 50
percent of individuals infected with HIV worldwide. In sub-Saharan Africa,
where the HIV/AIDS epidemic is most severe, women make up 57 percent of
individuals infected with HIV, and 75 percent of young people infected with HIV
in sub-Saharan Africa are young women ages 15 to 24.
(40)Women and girls are biologically, socially,
and economically more vulnerable to HIV infection. Gender disparities in the
rate of HIV infection are the result of a number of factors, including the
following:
(A)Cross-generational sex with older men who
are more likely to be infected with HIV, and a lack of choice regarding when
and whom to marry, leading to early marriages and high rates of child marriages
with older men. About one-half of all adolescent females in sub-Saharan Africa
and two-thirds of adolescent females in Asia are married by age 18.
(B)Studies show that married women and married
and unmarried girls often are unable or find it difficult to negotiate the
frequency and timing of sexual intercourse, ensure their partner's
faithfulness, or insist on condom use. Under these circumstances, women often
run the risk of being infected by husbands or male partners in societies where
men in relationships have more than one partner. Behavior change is
particularly important in societies in which this is a common practice.
(C)Because young married women and girls are
more likely to have unprotected sex and have more frequent sex than their
unmarried peers, and women and girls who are faithful to their spouses can be
placed at risk of HIV/AIDS through a husband’s infidelity or prior infection,
marriage is not always a guarantee against HIV infection, although it is a
protective factor overall.
(D)Social and economic inequalities based
largely on gender limit access for women and girls to education and employment
opportunities and prevent them from asserting their inheritance and property
rights. For many women, a lack of independent economic means combines with
socio-cultural practices to sustain and exacerbate their fear of abandonment,
eviction, or ostracism from their homes and communities and can leave many more
women trapped within relationships where they are vulnerable to HIV
infection.
(E)A lack of educational opportunities for
women and girls is linked to younger sexual debut, earlier childhood marriage,
earlier childbearing, decreased child survival, worsening nutrition, and
increased risk of HIV infection.
(F)High rates of gender-based violence, rape,
and sexual coercion within and outside marriage contribute to high rates of HIV
infection. According to the World Health Organization, between one-sixth and
three-quarters of women in various countries and settings have experienced some
form of physical or sexual violence since the age of 15 within or outside of
marriage. Women who are unable to protect themselves from such violence are
often unable to protect themselves from being infected with HIV through forced
sexual contact.
(G)Fear of domestic
violence and the continuing stigma and discrimination associated with HIV/AIDS
prevent many women from accessing information about HIV/AIDS, getting tested,
disclosing their HIV status, accessing services to prevent mother-to-child
transmission of HIV, or receiving treatment and counseling even when they
already know they have been infected with HIV.
(H)According to
UNAIDS, the vulnerability of individuals involved in commercial sex acts to HIV
infection is heightened by stigmatization and marginalization, limited economic
options, limited access to health, social, and legal services, limited access
to information and prevention means, gender-related differences and
inequalities, sexual exploitation and trafficking, harmful or non-protective
laws and policies, and exposure to risks associated with commercial sex acts,
such as violence, substance abuse, and increased mobility.
(I)Lack of access to
basic HIV prevention information and education and lack of coordination with
existing primary health care to reduce stigma and maximize coverage.
(J)Lack of access to
currently available female-controlled HIV prevention methods, such as the
female condom, and lack of training on proper use of either male or female
condoms.
(K)High rates of
other sexually transmitted infections and complications during pregnancies and
childbirth.
(L)An absence of
functioning legal frameworks to protect women and girls and, where such
frameworks exist, the lack of accountable and effective enforcement of such
frameworks.
(41)In addition to
vulnerabilities to HIV infection, women in sub-Saharan Africa face a 1-in-13
chance of dying in childbirth compared to a 1-in-16 chance in least-developed
countries worldwide, a 1-in-60 chance in developing countries, and a 1-in-4,100
chance in developed countries.
(42)Due to these high maternal mortality rates
and high HIV prevalence rates in certain countries, special attention is needed
in these countries to help HIV-positive women safely deliver healthy babies and
save women’s lives.
(43)Unprotected sex within or outside of
marriage is the single greatest factor in the transmission of HIV worldwide and
is responsible for 80 percent of new HIV infections in sub-Saharan
Africa.
(44)Multiple randomized controlled trials have
established that male circumcision reduces a man’s risk of contracting HIV by
60 percent or more. Twelve acceptability studies have found that in regions of
sub-Saharan Africa where circumcision is not traditionally practiced, a
majority of men want the procedure. Broader availability of male circumcision
services could prevent millions of HIV infections not only in men but also in
their female partners.
(45)(A)Youth also face
particular challenges in receiving services for HIV/AIDS.
(B)Nearly one-half of all orphans who have
lost one parent and two-thirds of those who have lost both parents are ages 12
to 17. These orphans are in particular need of services to protect themselves
against sexually-transmitted infections, including HIV.
(C)Research indicates that many youth benefit
from full disclosure of medically accurate, age-appropriate information about
abstinence, partner reduction, and condoms. Providing comprehensive information
about HIV, including delay of sexual debut and the ABC model: Abstain,
Be faithful, use Condoms
, and linking such information to health care
can help improve awareness of safe sex practices and address the fact that only
1 in 3 young men and 1 in 5 young women ages 15 to 24 can correctly identify
ways to prevent HIV infection.
(D)Surveys indicate that no country has
succeeded in fully educating more than one-half of its youth about the
prevention and transmission of HIV.
(46)According to the United Nations High
Commissioner for Refugees (UNHCR), HIV/AIDS prevalence rates among refugees are
generally lower than the HIV/AIDS prevalence rates for their host communities,
though perceptions run counter to this fact. However, peacekeeping operations
that no longer deploy HIV/AIDS-positive troops still face vulnerabilities to
sexual transmission of HIV with HIV-positive individuals in refugee camps. Host
countries generally do not provide HIV/AIDS prevention, treatment, and care
services for refugees.
(47)Continuing
progress to reach the millions of impoverished individuals who need voluntary
testing, counseling, treatment, and care for HIV/AIDS requires increased
efforts to strengthen health care delivery systems and infrastructure, rebuild
and expand the health care workforce, and strengthen allied and support
services in countries receiving United States global HIV/AIDS
assistance.
(48)While HIV/AIDS
poses the greatest health threat of modern times, it also poses the greatest
development challenge for developing countries with fragile economies and weak
public financial management systems that are ill equipped to shoulder the
burden of this disease. International donors will have to play a critical role
in providing resources for HIV/AIDS programs far into the future.
(49)The emerging
partnerships between countries most affected by HIV/AIDS and the United States
must include stronger coordination between HIV/AIDS programs and other United
States foreign assistance programs, and stronger collaboration with other
donors in the areas of economic development and growth strategies.
(50)The future
control of HIV/AIDS demands coordination between international organizations
such as the Global Fund to Fight AIDS, Tuberculosis and Malaria, UNAIDS, the
World Health Organization (WHO), the World Bank and the International Monetary
Fund (IMF), the international donor community, national governments, and
private sector organizations, including community and faith-based
organizations.
(51)The future
control of HIV/AIDS further requires effective and transparent public finance
management systems in developing countries to advance the ability of such
countries to manage public revenues and donor funds aimed at combating HIV/AIDS
and other diseases.
(52)The HIV/AIDS
pandemic contributes to the shortage of health care personnel through loss of
life and illness, unsafe working conditions, increased workloads for diminished
staff, and resulting stress and burnout, while the shortage of health care
personnel undermines efforts to prevent and provide care and treatment for
individuals with HIV/AIDS.
(53)The shortage of
health care personnel, including doctors, nurses, pharmacists, counselors,
laboratory staff, paraprofessionals, trained lay workers, and researchers is
one of the leading obstacles to combating HIV/AIDS in sub-Saharan
Africa.
(54)Since 2003, important progress has been
made in combating HIV/AIDS, yet there is more to be done. The number of new HIV
infections is still increasing at an alarming rate. According to the United
States National Institute of Allergy and Infectious Diseases, globally, for
every 1 individual put on antiretroviral therapy, 6 individuals are newly
infected with HIV.
(55)The United States
Government continues to be the world’s leader in the fight against HIV/AIDS and
the unsurpassed partner with developing countries in their efforts to control
this disease.
(56)By September 2007, the United States,
through the United States Leadership Against HIV/AIDS, Tuberculosis, and
Malaria Act of 2003 (22 U.S.C. 7601 et seq.), had provided services to prevent
mother-to-child-transmission of HIV to women during 10 million pregnancies;
provided antiretroviral prophylaxis for women during over 827,300 pregnancies;
prevented an estimated 157,240 HIV infections in infants; cared for over 6.6
million individuals, including over 2.7 million orphans and vulnerable
children; supported lifesaving antiretroviral therapies for approximately 1.4
million men, women, and children in sub-Saharan Africa, Asia, and the
Carribean; and provided counseling and testing to over 33.7 million men, women,
and children in developing countries.
(57)These numbers were
achieved because of the commitment of substantial resources and support of the
United States Government to our partners on the front lines—the dedicated and
committed women and men, communities, and nations who are taking control of the
HIV/AIDS epidemics in their own
countries.
.
3.Section 3(2) of the United States Leadership
Against HIV/AIDS, Tuberculosis, and Malaria Act of 2003 (22 U.S.C. 7602(2)) is
amended by striking Committee on International Relations
and
inserting Committee on Foreign Affairs
.
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 global leadership and the effectiveness of the United
States response to the HIV/AIDS, tuberculosis, and malaria pandemics and other
related and preventable infectious diseases in developing countries by—
(1)establishing a
comprehensive, integrated five-year, global strategy to fight HIV/AIDS,
tuberculosis, and malaria that encompasses a plan for continued expansion and
coordination of critical programs and improved coordination among relevant
executive branch agencies and between the United States and foreign governments
and international organizations;
(2)providing
increased resources for United States bilateral efforts to combat HIV/AIDS,
tuberculosis, and malaria, particularly for prevention, treatment, and care
(including nutritional support), technical assistance and training, the
strengthening of health care systems, health care workforce development,
monitoring and evaluations systems, and operations research;
(3)providing
increased resources for multilateral efforts to combat HIV/AIDS, tuberculosis,
and malaria;
(4)encouraging the
expansion of private sector efforts and expanding public-private sector
partnerships to combat HIV/AIDS; and
(5)intensifying
efforts to support the development of vaccines, microbicides, and other
prevention technologies and improved diagnostics treatment for HIV/AIDS,
tuberculosis, and
malaria.
.
<enum>I</enum><header>Policy planning
and coordination</header>
<section id="HA196D8CE673D434B9E74127245295C64"><enum>101.</enum><header>Development of
a comprehensive, five-year, global strategy</header>
<subsection id="H2D9D933FF2B947E8BC28DEEDF8EB6E8"><enum>(a)</enum><header>Strategy</header><text display-inline="yes-display-inline">Subsection (a) of section 101 of the United
States Leadership Against HIV/AIDS, Tuberculosis, and Malaria Act of 2003 (22
U.S.C. 7611) is amended—</text>
<paragraph id="HDA9B51E413064791B8FBE03400DCA33F"><enum>(1)</enum><text>in the first
sentence of the matter preceding paragraph (1), by striking <quote>to
combat</quote> and inserting <quote>to develop efforts further to
combat</quote>;</text>
</paragraph><paragraph id="HF7D34865C98B406B009100A2DC9BF65D"><enum>(2)</enum><text>by amending
paragraph (4) to read as follows:</text>
<quoted-block display-inline="no-display-inline" id="H7E916D246DD243E8A96D6275BEFCF1DA" style="OLC">
<paragraph id="H53CD2514A16846BCB4F0FE0004984952"><enum>(4)</enum><text display-inline="yes-display-inline">provide that the reduction of HIV/AIDS
behavioral risks shall be a priority of all prevention efforts in terms of
funding, scientifically-accurate educational services, and activities
by—</text>
<subparagraph id="H1F4DFE928AB34116960024E0F5BAFB3F"><enum>(A)</enum><text display-inline="yes-display-inline">designing prevention strategies and
programs based on sound epidemiological evidence, tailored to the unique needs
of each country and community, and reaching those populations found to be most
at risk for acquiring HIV infection;</text>
</subparagraph><subparagraph id="H32298CB13DC74F5B996300EE19CFB64B"><enum>(B)</enum><text>promoting
abstinence from sexual activity and substance abuse;</text>
</subparagraph><subparagraph id="HBF97D7836AE44A6C9998356FF0F38062"><enum>(C)</enum><text>encouraging delay
of sexual debut, monogamy, fidelity, and partner reduction;</text>
</subparagraph><subparagraph id="H644226F736AE4814BBB3B4BFA751CEC3"><enum>(D)</enum><text>promoting the
effective use of male and female condoms;</text>
</subparagraph><subparagraph id="H4375634DDE6A4F53AC82FB50A4F9A743"><enum>(E)</enum><text>promoting the use
of measures to reduce the risk of HIV transmission for discordant couples
(where one individual has HIV/AIDS and the other individual does not have
HIV/AIDS or whose status is unknown);</text>
</subparagraph><subparagraph id="H31BA2BDB318F4F62B6D936774400CFD7"><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="HC6931508E0D04FCDA97881DB31FC4F1"><enum>(G)</enum><text display-inline="yes-display-inline">promoting the rapid expansion of safe and
voluntary male circumcision services;</text>
</subparagraph><subparagraph id="HF8BB5C494BBE42279D28783F3F5090C9"><enum>(H)</enum><text>promoting life
skills training and development for children and youth;</text>
</subparagraph><subparagraph id="H792D2D85EF74471FBCB5D84E39E3B9AD"><enum>(I)</enum><text>supporting
advocacy for child and youth community-based protective social services;</text>
</subparagraph><subparagraph id="HFC7239B9AB994AFC951C00A0D7F7B52F"><enum>(J)</enum><text>eradicating
trafficking in persons and creating alternatives to prostitution;</text>
</subparagraph><subparagraph id="H6B53B38107724148B04289E600F4B6EE"><enum>(K)</enum><text>promoting
cooperation with law enforcement to prosecute offenders of trafficking, rape,
and sexual assault crimes with the goal of eliminating such crimes;</text>
</subparagraph><subparagraph id="H3912F7C08D1E4004BD4421A5B7B0AABA"><enum>(L)</enum><text>promoting services
demonstrated to be effective in reducing the transmission of HIV infection
among injection drug users without increasing illicit drug use;</text>
</subparagraph><subparagraph id="H9E02C8777C9A4CB8857C2F9B761107A9"><enum>(M)</enum><text>promoting policies
and programs to end the sexual exploitation of and violence against women and
children; and</text>
</subparagraph><subparagraph id="HED740E631D184AC6B21B842569A8CF97"><enum>(N)</enum><text>promoting
prevention and treatment services for men who have sex with
men;</text>
</subparagraph></paragraph><after-quoted-block>;</after-quoted-block></quoted-block>
</paragraph><paragraph id="HF78545BAD5434DB8006C097E00BD84BB"><enum>(3)</enum><text>by redesignating
paragraphs (5) through (10) as paragraphs (6) through (11),
respectively;</text>
</paragraph><paragraph id="H757C4BE8E7E04A58A76F7FCF5C8E145"><enum>(4)</enum><text>by
inserting after paragraph (4) (as amended by paragraph (2) of this subsection)
the following:</text>
<quoted-block display-inline="no-display-inline" id="H5CCEB35125914E1B900909BC8C05E863" style="OLC">
<paragraph id="H92DFB81D51064B6D90F80337001B5204"><enum>(5)</enum><text display-inline="yes-display-inline">include specific plans for linkage to, and
referral systems for nongovernmental organizations that implement multisectoral
approaches, including faith-based and community-based organizations,
for—</text>
<subparagraph id="H5EF3508112434075ABE504B0E53915E"><enum>(A)</enum><text>nutrition and food
support for individuals with HIV/AIDS and affected communities;</text>
</subparagraph><subparagraph id="H2758D9C03E7F42CD919F105071D396C"><enum>(B)</enum><text>child health
services and development programs;</text>
</subparagraph><subparagraph id="H5CC670C3DA92445B8547B5CA90F5BEA"><enum>(C)</enum><text>HIV/AIDS prevention
and treatment services for injection drug users;</text>
</subparagraph><subparagraph id="HFC22E9B356234A01000164426CD5A8CB"><enum>(D)</enum><text>access to HIV/AIDS
education and testing in family planning and maternal health programs supported
by the United States Government; and</text>
</subparagraph><subparagraph id="H7421B4E28AD648E892C10092DE40F5C"><enum>(E)</enum><text>medical, social,
and legal services for victims of
violence;</text>
</subparagraph></paragraph><after-quoted-block>;</after-quoted-block></quoted-block>
</paragraph><paragraph id="H64250F1DD1504A2CA0B955DB0078EF31"><enum>(5)</enum><text>by redesignating
paragraphs (10) and (11) (as redesignated by paragraph (3) of this subsection)
as paragraphs (11) and (12), respectively; and</text>
</paragraph><paragraph id="HE6311FB037894D2D94353C514F69C00"><enum>(6)</enum><text display-inline="yes-display-inline">by inserting after paragraph (9) (as
redesignated by paragraph (3) of this subsection) the following:</text>
<quoted-block display-inline="no-display-inline" id="H58D6C75D31334599A2EC902D52006F20" style="OLC">
<paragraph id="H4D413DEA02A14258B669AAF32BB9A8B6"><enum>(10)</enum><text display-inline="yes-display-inline">maximize host country capacities in
training and research, particularly operations
research;</text>
</paragraph><after-quoted-block>.</after-quoted-block></quoted-block>
</paragraph></subsection><subsection id="H7A6AF84A94BD45EBA9FD039150A7A082"><enum>(b)</enum><header>Report</header><text>Subsection
(b) of such section is amended—</text>
<paragraph id="H4055321200DB41CABB50E0B2EC8ED5FA"><enum>(1)</enum><text>in paragraph (1),
by striking <quote>this Act</quote> and inserting <quote>the Tom Lantos and
Henry J. Hyde Global Leadership Against HIV/AIDS, Tuberculosis, and Malaria
Reauthorization Act of 2008</quote>; and</text>
</paragraph><paragraph id="H0B59C2DC91374B90B1DADE1300BFE21D"><enum>(2)</enum><text>in paragraph
(3)—</text>
<subparagraph id="H805A7284F9274230AF5155FC9B48122C"><enum>(A)</enum><text>by amending
subparagraph (C) to read as follows:</text>
<quoted-block display-inline="no-display-inline" id="HE79EF95F18024E560010B52BDCD562B4" style="OLC">
<subparagraph id="HFA99E540200F463CB6F4CFF5EF0131CC"><enum>(C)</enum><text display-inline="yes-display-inline">A description of the manner in which the
strategy will address the following:</text>
<clause id="HFB70429B55D94399BCF82EBA61DF98E6"><enum>(i)</enum><text>The fundamental
elements of prevention and education, care and treatment, including increasing
access to pharmaceuticals, vaccines, and microbicides, as they become
available, screening, prophylaxis, and treatment of major opportunistic
infections, including tuberculosis, and increasing access to nutrition and food
for individuals on antiretroviral therapies.</text>
</clause><clause id="H4789DABF1ECA445C9097E46F67B607"><enum>(ii)</enum><text>The
promotion of delay of sexual debut, abstinence, monogamy, fidelity, and partner
reduction.</text>
</clause><clause id="H1154EE73F55345FA8025618300D32E94"><enum>(iii)</enum><text>The promotion of
correct and consistent use of male and female condoms and other strategies and
skills development to reduce the risk of HIV transmission.</text>
</clause><clause id="H3B1F3B9FC144411D8F2562238CAB9C2D"><enum>(iv)</enum><text>Increasing
voluntary access to safe male circumcision services.</text>
</clause><clause id="HCFFBC89E510A4773B6BC88D8B1D388A3"><enum>(v)</enum><text>Life-skills
training.</text>
</clause><clause id="H0262B8224840413D9D94D8CAE99F2ED3"><enum>(vi)</enum><text>The provision of
information and services to encourage young people to delay sexual debut and
ensure access to HIV/AIDS prevention information and services.</text>
</clause><clause id="HB369816A27B64DC5A35F171C184F9693"><enum>(vii)</enum><text display-inline="yes-display-inline">Prevention of sexual violence leading to
transmission of HIV and assistance for victims of violence who are at risk of
HIV transmission.</text>
</clause><clause id="H823B3EFE56794CD0A115E4FA897FA35E"><enum>(viii)</enum><text display-inline="yes-display-inline">HIV/AIDS prevention, care, and treatment
services for injection drug users.</text>
</clause><clause id="H3D85BF6DA66045D085C5B19C007186C1"><enum>(ix)</enum><text display-inline="yes-display-inline">Research, including incentives for HIV
vaccine development and new protocols.</text>
</clause><clause id="H9367C36DFBFB476694AB03CA30ACB9C6"><enum>(x)</enum><text>Advocacy for
community-based child and youth protective services.</text>
</clause><clause id="H1B70E2F9FA7C400CBB06291D19EAFADD"><enum>(xi)</enum><text>Training of
health care workers.</text>
</clause><clause id="HBB8EE95B51EB438CBB9786D156752837"><enum>(xii)</enum><text>The development
of health care infrastructure and delivery systems.</text>
</clause><clause id="H9780D6F4610A4654A70305AEFF42D996"><enum>(xiii)</enum><text>Prevention
efforts for substance abusers.</text>
</clause><clause id="H93AF769B23AA4A9798885C98A8E657E2"><enum>(xiv)</enum><text>Prevention,
treatment, care, and outreach efforts for men who have sex with
men.</text>
</clause></subparagraph><after-quoted-block>;</after-quoted-block></quoted-block>
</subparagraph><subparagraph id="HD042B1B6983F400DAB2CE9370750B16C"><enum>(B)</enum><text>in subparagraph
(D), by adding at the end before the period the following: <quote>, including
through faith-based and other nongovernmental organizations</quote>;</text>
</subparagraph><subparagraph id="H806A1043CE6C442E9013E2FB6F40B085"><enum>(C)</enum><text>in subparagraph
(E), by inserting <quote>access to HIV/AIDS education and testing in family
planning and maternal and child health programs supported by the United States
Government and</quote> after <quote>the unique needs of women,
including</quote>;</text>
</subparagraph><subparagraph id="H144149E3E360477983D93E07B410037"><enum>(D)</enum><text>in subparagraph
(F), by inserting <quote>(including by accessing voluntary clinical
circumcision services)</quote> after <quote>in their sexual
behavior</quote>;</text>
</subparagraph><subparagraph id="HD5E90241477F4569A5741EF662C0D272"><enum>(E)</enum><text>in subparagraph
(G), by inserting <quote>and men’s</quote> after <quote>women’s</quote>;</text>
</subparagraph><subparagraph id="HD2ECA11738454330A75C75CA6182A6D5"><enum>(F)</enum><text>by redesignating
subparagraphs (M) through (W) as subparagraphs (N) through (X);</text>
</subparagraph><subparagraph id="H72031F468ACA468696008055BFE74F1B"><enum>(G)</enum><text>by inserting after
subparagraph (L) the following:</text>
<quoted-block display-inline="no-display-inline" id="HA5CCD2117C764408B3C5F0053EF01B9B" style="OLC">
<subparagraph id="HC48A31017AF94DCBB12031C244CDD585"><enum>(M)</enum><text display-inline="yes-display-inline">A description of efforts to be undertaken
to strengthen the public finance management systems of selected host countries
to ensure transparent, efficient, and effective management of national and
donor financial investments in
health.</text>
</subparagraph><after-quoted-block>;</after-quoted-block></quoted-block>
</subparagraph><subparagraph id="HC650AF94A75E4FA6A6A5116DE4D9B021"><enum>(H)</enum><text>in subparagraph
(O) (as redesignated by subparagraph (F) of this paragraph), by striking
<quote>evaluating programs,</quote> and inserting <quote>evaluating programs to
ensure medical accuracy, operations research,</quote>;</text>
</subparagraph><subparagraph id="HE189758E1344464CA6D238E516031DDF"><enum>(I)</enum><text display-inline="yes-display-inline">in subparagraph (Q) (as redesignated by
subparagraph (F) of this paragraph), by inserting <quote>, strengthen national
health care delivery systems, and increase national health workforce
capacities,</quote> after <quote>HIV/AIDS pandemic</quote>;</text>
</subparagraph><subparagraph id="HB9FC004AEFE543DBA5D937B0BBA6B0D8"><enum>(J)</enum><text display-inline="yes-display-inline">in subparagraph (R) (as redesignated by
subparagraph (F) of this paragraph), by inserting at the end before the period
the following: <quote>, including strategies relating to agricultural
development, trade and economic growth, and education</quote>;</text>
</subparagraph><subparagraph id="H81B296451D504A0E8DFD9B8D8729C9C6"><enum>(K)</enum><text display-inline="yes-display-inline">in subparagraph (T) (as redesignated by
subparagraph (F) of this paragraph), by inserting <quote>efforts of
intergenerational caregivers and</quote> after <quote>,
including</quote>;</text>
</subparagraph><subparagraph id="H483DBD3C962A4A76B6481421CCCA1818"><enum>(L)</enum><text display-inline="yes-display-inline">by redesignating subparagraphs (V) through
(X) (as redesignated by subparagraph (F) of this paragraph), as subparagraphs
(W) through (Y), respectively;</text>
</subparagraph><subparagraph id="H088EC6F1CF304FCC903EA5233ECC24E3"><enum>(M)</enum><text display-inline="yes-display-inline">by inserting after subparagraph (U) (as
redesignated by subparagraph (F) of this paragraph) the following:</text>
<quoted-block display-inline="no-display-inline" id="H558CC2C70F35444295121000872C6289" style="OLC">
<subparagraph id="H1CA70217203B404DAD1CADD7C4A218BB"><enum>(V)</enum><text display-inline="yes-display-inline">A plan to strengthen and implement health
care workforce strategies to enable countries to increase the supply and
retention of all cadres of trained professional and paraprofessional health
care workers by numbers that move toward global health program needs and toward
targets established by the World Health Organization, while enabling health
systems to expand coverage consistent with national and international targets
and goals.</text>
</subparagraph><after-quoted-block>;
and</after-quoted-block></quoted-block>
</subparagraph><subparagraph id="H36C2DE51E3014B098B5022A470925806"><enum>(N)</enum><text display-inline="yes-display-inline">by striking subparagraph (Y) (as
redesignated by subparagraphs (F) and (L) of this paragraph) and inserting the
following:</text>
<quoted-block display-inline="no-display-inline" id="H2EC777FC2393499B98D922AD3AE648E" style="OLC">
<subparagraph id="H2073FF6ED041433A8309AEEBC36BFF11"><enum>(Y)</enum><text display-inline="yes-display-inline">A description of the specific strategies,
developed in coordination with existing health programs, to prevent
mother-to-child transmission of HIV, including the extent to which HIV-positive
women and men in treatment, care, and support programs and HIV-negative women
and men are counseled about methods of preventing HIV transmission and the
extent to which HIV prevention methods are provided on-site or by referral in
treatment, care, and support programs.</text>
</subparagraph><subparagraph id="H06B7DFE7B7BE40FDAA7E99772DD94B84"><enum>(Z)</enum><text>A description of
the specific strategies developed to maximize the capacity of health care
providers, including faith-based and other nongovernmental organizations, and
family planning providers supported by the United States Government to ensure
access to necessary and comprehensive information about reducing sexual
transmission of HIV among women, men, and young people, including strategies to
ensure HIV/AIDS prevention training for such providers.</text>
</subparagraph><subparagraph id="H6DB067673ED24A20BC099F5869352221"><enum>(AA)</enum><text>A strategy to
work with international and host country partners toward universal access to
HIV/AIDS prevention, treatment, and care
programs.</text>
</subparagraph><after-quoted-block>.</after-quoted-block></quoted-block>
</subparagraph></paragraph></subsection><subsection id="H2E07D75C41FE45B2A61B3DA36F9F1339"><enum>(c)</enum><header>Strategic plan
for program monitoring, operations research, and impact evaluation
research</header>
<paragraph id="H98D8E4B2A37F461E00428D008948F1C7"><enum>(1)</enum><header>In
general</header><text>Not later than 1 year after the date of the enactment of
this Act, the Coordinator of United States Government Activities to Combat
HIV/AIDS Globally shall develop a 5-year strategic plan for program monitoring,
operations research, and impact evaluation research of United States HIV/AIDS,
tuberculosis, and malaria programs.</text>
</paragraph><paragraph id="H466A532E46D34E3B826DE3E2ACB900F4"><enum>(2)</enum><header>Elements of
plan</header><text>The strategic plan developed under this subsection shall
include—</text>
<subparagraph id="HB542B8A32B094A3781D6579B28F10032"><enum>(A)</enum><text display-inline="yes-display-inline">the amount of funding provided for program
monitoring, operations research, and impact evaluation research under 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) and the United States Leadership Against HIV/AIDS,
Tuberculosis, and Malaria Act of 2003 (<external-xref legal-doc="usc" parsable-cite="usc/22/7601">22 U.S.C. 7601 et seq.</external-xref>) available
through fiscal year 2009;</text>
</subparagraph><subparagraph id="H69C23D44F9FD438EBA1D1B6100EDE37C"><enum>(B)</enum><text>strategies
to—</text>
<clause id="H7AC97BD84F5F48B19501887250DFB63"><enum>(i)</enum><text>improve the
efficiency, effectiveness, quality, and accessibility of services provided
under the provisions of law described in subparagraph (A);</text>
</clause><clause id="H3F4804148A7F40AC948DF9E4EEE4400"><enum>(ii)</enum><text>establish the
cost-effectiveness of program models;</text>
</clause><clause id="H56FED8D9DF83493CBBAF0640F17FEEBD"><enum>(iii)</enum><text>ensure the
transparency and accountability of services provided under the provisions of
law described in subparagraph (A);</text>
</clause><clause id="H725EBF39036E4C718FD0E50002835F20"><enum>(iv)</enum><text>disseminate and
promote the utilization of evaluation findings, lessons, and best practices in
services provided under the provisions of law described in subparagraph (A);
and</text>
</clause><clause id="HF8A8D6E2587D4B828842EBD66C3E6987"><enum>(v)</enum><text>encourage and
evaluate innovative service models and strategies to optimize the delivery of
care, treatment, and prevention programs financed by the United States
Government;</text>
</clause></subparagraph><subparagraph id="H0B6369B9FFC64ACC8FD877F687C33EAF"><enum>(C)</enum><text>priorities for
program monitoring, operations research, and impact evaluation research and a
time line for completion of activities associated with such priorities;
and</text>
</subparagraph><subparagraph id="HF6845D8FC8034DBE93002C3C657F2665"><enum>(D)</enum><text>other information
that the Coordinator determines to be necessary.</text>
</subparagraph></paragraph><paragraph id="H9206B1BD85C7492497008F1F64AE8A3"><enum>(3)</enum><header>Consultation</header><text>In
developing the strategic plan under this subsection and implementing,
disseminating, and promoting the use of program monitoring, operations
research, and impact evaluation research, the Coordinator shall consult with
representatives of relevant executive branch agencies, other appropriate
executive branch agencies, multilateral institutions involved in providing
HIV/AIDS assistance, nongovernmental organizations involved in implementing
HIV/AIDS programs, and the governments of host countries.</text>
</paragraph><paragraph id="HB4E25110A2CC4748ABB57C3033E6FA5"><enum>(4)</enum><header>Definitions</header><text>In
this subsection—</text>
<subparagraph id="H4D3B255B37E5496B837C2B72B3613F69"><enum>(A)</enum><text display-inline="yes-display-inline">the terms <term>program monitoring</term>,
<term>operations research</term>, and <term>impact evaluation research</term>,
have the meanings given such terms in section 104A(d)(4)(B) of the Foreign
Assistance Act of 1961 (as added by section 301(a)(4)(C) of this Act);
and</text>
</subparagraph><subparagraph id="H2F95DEB255394719BC5B19A3CCB54304"><enum>(B)</enum><text display-inline="yes-display-inline">the term <term>relevant executive branch
agencies</term> has the meaning given the term in section 3 of the United
States Leadership Against HIV/AIDS, Tuberculosis, and Malaria Act of 2003 (22
U.S.C. 7602).</text>
</subparagraph></paragraph></subsection></section><section id="H9220DC543E9847EF9E413FC995445F4B"><enum>102.</enum><header>HIV/AIDS
Response Coordinator</header><text display-inline="no-display-inline">Section
1(f)(2) of the State Department Basic Authorities Act of 1956 (22 U.S.C.
2651a(f)(2)) is amended—</text>
<paragraph id="HA4F7E569CB524148865E4FD8BFB1A454"><enum>(1)</enum><text>in subparagraph
(A)—</text>
<subparagraph id="H750F4AFC30D54F9D9DBEE1C140C2EF96"><enum>(A)</enum><text>in the matter
preceding clause (i), by inserting <quote>, host country finance, health, and
other relevant ministries</quote> after “community-based organizations)”;
and</text>
</subparagraph><subparagraph id="H38689F286D784F50967BBE00D3F51FAE"><enum>(B)</enum><text>in clause (iii),
by inserting <quote>and host country finance, health, and other relevant
ministries</quote> after <quote>community-based organizations)</quote>;
and</text>
</subparagraph></paragraph><paragraph id="H19071C5885A44699A607C99CDB946C5C"><enum>(2)</enum><text>in subparagraph
(B)(ii)—</text>
<subparagraph id="HBC155E955A9A44978554927F50F2B7F2"><enum>(A)</enum><text display-inline="yes-display-inline">by striking subclauses (IV) and (V) and
inserting the following:</text>
<quoted-block display-inline="no-display-inline" id="H289D821121D64D60AB9176BEEBA32958" style="OLC">
<subclause id="H8BBDBA6DF93443C89937ED6428589C2B"><enum>(IV)</enum><text display-inline="yes-display-inline">Establishing an interagency working group
on HIV/AIDS that is comprised of, but not limited to, representatives from the
United States Agency for International Development, the Department of Health
and Human Services (including the Centers for Disease Control and Prevention,
the National Institutes of Health, and the Health Resources and Services
Administration), the Department of Labor, the Department of Agriculture, the
Millennium Challenge Corporation, the Department of Defense, and the Office of
the Coordinator of United States Government Activities to Combat Malaria
Globally, for the purposes of coordination of activities relating to HIV/AIDS.
The interagency working group shall—</text>
<item id="H8C975FA4AEE34DADA4009B905CC52476"><enum>(aa)</enum><text>meet regularly to
review progress in host countries toward HIV/AIDS prevention, treatment, and
care objectives;</text>
</item><item id="HD3FFDB5FA2A140E7A793FA9931AC01BD"><enum>(bb)</enum><text>participate in
the process of identifying countries in need of increased assistance based on
the epidemiology of HIV/AIDS in those countries; and</text>
</item><item id="H42AA81FE2A594DF0A4CF1257E6FD1082"><enum>(cc)</enum><text>review policies
that may be obstacles to reaching objectives set forth for HIV/AIDS prevention,
treatment, and care.</text>
</item></subclause><subclause id="HE3EBA0DD160B4534A35FFCDB73301FE8"><enum>(V)</enum><text display-inline="yes-display-inline">Coordinating overall United States HIV/AIDS
policy and programs with efforts led by host countries and with the assistance
provided by other relevant bilateral and multilateral aid agencies and other
donor institutions to achieve complementarity with other programs aimed at
improving child and maternal health, and food security, promoting education,
and strengthening health care
systems.</text>
</subclause><after-quoted-block>;</after-quoted-block></quoted-block>
</subparagraph><subparagraph id="HBDF2E01C0818480CBEA9C3FC9800B3D7"><enum>(B)</enum><text>by redesignating
subclauses (VII) and (VIII) as subclauses (IX) and (X), respectively;</text>
</subparagraph><subparagraph id="HE6CCCAB7F0BE4B2AA5A217DD6778BFF"><enum>(C)</enum><text>by inserting after
subclause (VI) the following:</text>
<quoted-block display-inline="no-display-inline" id="H071BBD88084140F783657100122B185D" style="OLC">
<subclause display-inline="no-display-inline" id="H5CCF6AD722714AC6B4C92E98A192A7F6"><enum>(VII)</enum><text display-inline="yes-display-inline">Holding annual consultations with host
country nongovernmental organizations providing services to improve health, and
advocating on behalf of the individuals with HIV/AIDS and those at particular
risk of contracting HIV/AIDS.</text>
</subclause><subclause commented="no" id="H02B78E1D336944F9AE35CE089E6195E4"><enum>(VIII)</enum><text display-inline="yes-display-inline">Ensuring, through interagency and
international coordination, that United States HIV/AIDS programs are
coordinated with and complementary to the delivery of related global health,
food security, and education services, including—</text>
<item commented="no" id="H0C839A00EC764E39B8F121945D5C24CF"><enum>(aa)</enum><text>maternal and
child health care;</text>
</item><item commented="no" id="H1995B47F664540989504DE3CE601E38E"><enum>(bb)</enum><text>services for
other neglected and easily preventable and treatable infectious diseases, such
as tuberculosis;</text>
</item><item commented="no" id="H0312E52248954D34990001E3B023B92F"><enum>(cc)</enum><text>treatment and
care services for injection drug users; and</text>
</item><item id="H0BD4B21C966D41D1B84D18C8FC9B08D8"><enum>(dd)</enum><text display-inline="yes-display-inline">programs and services to improve legal,
social, and economic status of women and
girls.</text>
</item></subclause><after-quoted-block>;</after-quoted-block></quoted-block>
</subparagraph><subparagraph commented="no" id="H0025E08210874F6FB427CF63C9573D32"><enum>(D)</enum><text display-inline="yes-display-inline">in subclause (IX) (as redesignated by
subparagraph (B) of this paragraph)—</text>
<clause commented="no" id="H276367FF82C74CD795752602F2DED222"><enum>(i)</enum><text display-inline="yes-display-inline">by inserting <quote>Vietnam, Antigua and
Barbuda, the Bahamas, Barbados, Belize, Dominica, Grenada, Jamaica, Montserrat,
Saint Kitts and Nevis, Saint Vincent and the Grenadines, Saint Lucia, Suriname,
Trinidad and Tobago, the Dominican Republic, Malawi, Swaziland, Lesotho</quote>
after <quote>Zambia,</quote>;</text>
</clause><clause id="H9B87639485014E64BB80E1AD004D8687"><enum>(ii)</enum><text>by
adding at the end before the period the following: <quote>and other countries
in which the United States is implementing HIV/AIDS programs</quote>;
and</text>
</clause><clause id="H8079C1FBCDA349E7B4DD313F7939E33C"><enum>(iii)</enum><text>by
adding at the end the following: <quote>In designating countries under this
subclause, the President shall give priority to those countries in which there
is a high prevalence of HIV/AIDS and countries with large populations that have
a concentrated HIV/AIDS epidemic.</quote>;</text>
</clause></subparagraph><subparagraph commented="no" id="HC417BEEDCBF743778615767B13A460C6"><enum>(E)</enum><text display-inline="yes-display-inline">by redesignating subclause (X) (as
redesignated by subparagraph (B) of this paragraph) as subclause (XII);</text>
</subparagraph><subparagraph commented="no" id="HFB84B73D4E4441B89DBA9B1FEDFCC5"><enum>(F)</enum><text display-inline="yes-display-inline">by inserting after subclause (IX) (as
redesignated by subparagraph (B) and amended by subparagraph (D) of this
paragraph) the following:</text>
<quoted-block display-inline="no-display-inline" id="H4EA696293BB242EF8DD30373956C88FA" style="OLC">
<clause commented="no" id="H400E1C4DA9154BD3AC80F9D709E7003F"><enum>(X)</enum><text display-inline="yes-display-inline">Working, in partnership with host countries
in which the HIV/AIDS epidemic is prevalent among injection drug users, to
establish, as a national priority, national HIV/AIDS prevention programs,
including education, and services demonstrated to be effective in reducing the
transmission of HIV infection among injection drug users without increasing
drug use.</text>
</clause><clause commented="no" id="H2F047231FF2243EC9C90C7F89ACF17"><enum>(XI)</enum><text display-inline="yes-display-inline">Working, in partnership with host 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 create alternatives to
prostitution.</text>
</clause><after-quoted-block>;
</after-quoted-block></quoted-block>
</subparagraph><subparagraph id="H0E7C873D6FF1478DAACECFED614DD22F"><enum>(G)</enum><text display-inline="yes-display-inline">in subclause (XII) (as redesignated by
subparagraphs (B) and (E) of this paragraph), by striking <quote>funds
section</quote> and inserting <quote>funds appropriated pursuant to the
authorization of appropriations under section 401 of the United States
Leadership Against HIV/AIDS, Tuberculosis, and Malaria Act of 2003 for HIV/AIDS
assistance</quote>; and</text>
</subparagraph><subparagraph id="HEDEAD32C0C2F44A38891D13293843372"><enum>(H)</enum><text>by adding at the
end the following:</text>
<quoted-block display-inline="no-display-inline" id="H2A5F0AC4311B4DBBBE00287507B8D826" style="OLC">
<subclause id="HD78094E0030B46AEBEB8D300C3030046"><enum>(XIII)</enum><text display-inline="yes-display-inline">Publicizing updated drug pricing data to
inform pharmaceutical procurement partners’ purchasing decisions.</text>
</subclause><subclause commented="no" id="H108BF16DC4304B2EB316001B5FDA4B38"><enum>(XIV)</enum><text display-inline="yes-display-inline">Working in partnership with host countries
in which the HIV/AIDS epidemic is prevalent among men who have sex with men, to
establish, as a national priority, national HIV/AIDS prevention programs,
including education and services demonstrated to be effective in reducing the
transmission of HIV among men who have sex with
men.</text>
</subclause><after-quoted-block>.</after-quoted-block></quoted-block>
</subparagraph></paragraph></section><enum>II</enum><header>Support for
multilateral funds, programs, and public-private partnerships</header>
<section id="HA1AE34B140C04D8DB5376FFB7F78C5B2"><enum>201.</enum><header>Sense of
Congress on public-private partnerships</header><text display-inline="no-display-inline">Section 201(a) of the United States
Leadership Against HIV/AIDS, Tuberculosis, and Malaria Act of 2003 (22 U.S.C.
7621(a)) is amended—</text>
<paragraph id="H2F8101907732438FA3178C5F2821E6F4"><enum>(1)</enum><text>in paragraph (2),
by striking <quote>infectious diseases</quote> and inserting <quote>easily
preventable and treatable infectious diseases</quote>; and</text>
</paragraph><paragraph id="H3B13E043871E4E418ECABED5A7F88B77"><enum>(2)</enum><text display-inline="yes-display-inline">in paragraph (4), by striking
<quote>infectious diseases</quote> and inserting <quote>easily preventable and
treatable infectious diseases</quote>.</text>
</paragraph></section><section id="H9D5EF3179BF74A459201E288165834F"><enum>202.</enum><header>Participation in
the Global Fund to Fight AIDS, Tuberculosis and Malaria</header>
<subsection id="H00531C5138CB456EA2F29B00BFB3B4C0"><enum>(a)</enum><header>Findings</header><text display-inline="yes-display-inline">Subsection (a) of section 202 of the United
States Leadership Against HIV/AIDS, Tuberculosis, and Malaria Act of 2003 (22
U.S.C. 7622) is amended—</text>
<paragraph id="H104E095E15874E38836D10BE9288B799"><enum>(1)</enum><text>by redesignating
paragraphs (1) through (3) as paragraphs (7) through (9), respectively;
and</text>
</paragraph><paragraph id="H522605D95FDF49F2913BC0BE370943B3"><enum>(2)</enum><text>by inserting
before paragraph (7) (as redesignated by paragraph (1) of this subsection) the
following:</text>
<quoted-block display-inline="no-display-inline" id="H2BC31B8399BC44EF93E250A8EAE25A9" style="OLC">
<paragraph id="HC5013BEFE1A845AEA33EB33510F3EA15"><enum>(1)</enum><text display-inline="yes-display-inline">The Global Fund to Fight AIDS, Tuberculosis
and Malaria is the multilateral component of this Act, extending United States
efforts to a total of 136 countries around the world.</text>
</paragraph><paragraph id="H5565C64DBDAD47C7B9FF317CA7FD6934"><enum>(2)</enum><text display-inline="yes-display-inline">Created in 2002, the Global Fund has played
a leading role in the fight against HIV/AIDS, tuberculosis, and malaria around
the world and has grown into an organization that currently provides nearly a
quarter of all international financing to combat HIV/AIDS and two-thirds of all
international financing to combat tuberculosis and malaria.</text>
</paragraph><paragraph id="H8A5E938B8FD8453EA6D850009500BEB5"><enum>(3)</enum><text>By 2010, it is
estimated that the demand for funding by the Global Fund will grow in size to
between $6 and $8 billion annually, requiring significant contributions from
donors around the world, including at least $2 billion annually from the United
States.</text>
</paragraph><paragraph id="H3286FFB8DEAC4B0300A4C6D752A3728C"><enum>(4)</enum><text display-inline="yes-display-inline">The Global Fund is an innovative financing
mechanism to combat HIV/AIDS, tuberculosis, and malaria, and has made progress
in many areas.</text>
</paragraph><paragraph id="H5751EDFF666C44D4A3CB5F3973C04468"><enum>(5)</enum><text display-inline="yes-display-inline">The United States Government is the largest
supporter of the Global Fund, both in terms of resources and technical
support.</text>
</paragraph><paragraph id="H4E292AAACED1494192C5E93C470038B8"><enum>(6)</enum><text display-inline="yes-display-inline">The United States made the initial
contribution to the Global Fund and is fully committed to its
success.</text>
</paragraph><after-quoted-block>.</after-quoted-block></quoted-block>
</paragraph></subsection><subsection id="H88C0F89A9C6346CBA5BE7A02EF3035B"><enum>(b)</enum><header>United States
financial participation</header>
<paragraph id="H8CF58E4E71FC47FFBF34A5C1A83D0599"><enum>(1)</enum><header>Authorization of
appropriations</header><text display-inline="yes-display-inline">Subsection
(d)(1) of such section is amended—</text>
<subparagraph id="H9B9F5CA43CF34690814BC947F141DC9"><enum>(A)</enum><text>by striking
<quote>$1,000,000,000</quote> and inserting
<quote>$2,000,000,000</quote>;</text>
</subparagraph><subparagraph id="HB10C3A03A1DB47FA9138A39768950004"><enum>(B)</enum><text>by striking
<quote>for the period of fiscal year 2004 beginning on January 1, 2004,</quote>
and inserting <quote>for each of the fiscal years 2009 and 2010,</quote>;
and</text>
</subparagraph><subparagraph id="H485371F5FA22464ABDC92B82DDAB5FCC"><enum>(C)</enum><text>by striking
<quote>the fiscal years 2005–2008</quote> and inserting <quote>each of the
fiscal years 2011 through 2013</quote>.</text>
</subparagraph></paragraph><paragraph id="HB8283ADBDECC402898FF9D6D4142D834"><enum>(2)</enum><header>Limitation</header><text>Subsection
(d)(4) of such section is amended—</text>
<subparagraph id="HDB241E7DC0804A25AF00CFB9128D3714"><enum>(A)</enum><text>in subparagraph
(A)—</text>
<clause id="HF596EE5C7B7745BE9B74EE439DCF095"><enum>(i)</enum><text display-inline="yes-display-inline">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="HAC74B65AD57D4472BB07E3F01191A25E"><enum>(ii)</enum><text>in
clause (ii), by striking <quote>fiscal years 2004 through 2008</quote> and
inserting <quote>fiscal years 2009 through 2013</quote>; and</text>
</clause><clause id="H7587BA7017534F9F96CE933199957486"><enum>(iii)</enum><text>in
clause (vi)—</text>
<subclause id="H936DFDE2212A4D92B6CAB599D8BB2891"><enum>(I)</enum><text>by striking
<quote>for the purposes</quote> and inserting <quote>For the
purposes</quote>;</text>
</subclause><subclause id="H413B17EB229A4B59B6844DC9B987FB8F"><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="H614EE6C0D9F141C691E4CB388690C352"><enum>(III)</enum><text>by striking
<quote>fiscal year 2004</quote> and inserting <quote>fiscal year
2009</quote>;</text>
</subclause></clause></subparagraph><subparagraph id="H8BE12889A1154128A2A0339E79842D35"><enum>(B)</enum><text display-inline="yes-display-inline">in subparagraph (B)(iv)—</text>
<clause id="H150FA57CDD5C4EB181A4C4CF83F4FF80"><enum>(i)</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>
</clause><clause id="H2F9D5593B01D40538705A12F2C6956B5"><enum>(ii)</enum><text display-inline="yes-display-inline">by adding at the end before the period the
following: <quote>, unless such amount is made available for more than one
fiscal year, in which case such amount is authorized to be made available for
such purposes after December 31 of the fiscal year following the fiscal year in
which such funds first became available.</quote>; and</text>
</clause></subparagraph><subparagraph id="H99768493D46748A98E002B1009526301"><enum>(C)</enum><text>in subparagraph
(C)(ii) by striking <quote>Committee on International Relations</quote> and
inserting <quote>Committee on Foreign Affairs</quote>.</text>
</subparagraph></paragraph><paragraph id="HD15CD7A3926C4584AA004814ADEA452C"><enum>(3)</enum><header>Statement of
policy</header><text display-inline="yes-display-inline">The following shall be
the policy of the United States:</text>
<subparagraph id="H47CF3A70A1214631AB00C74BADD35521"><enum>(A)</enum><text display-inline="yes-display-inline">Support for the Global Fund to Fight AIDS,
Tuberculosis and Malaria should be based upon achievement of the following
benchmarks related to transparency and accountability:</text>
<clause id="HFD9A64F0BE6A4601977D51D9D896594C"><enum>(i)</enum><text>As
recommended by the Government Accountability Office, the Fund Secretariat has
established standardized expectations for the performance of Local Fund Agents
(LFAs), is undertaking a systematic assessment of the performance of LFAs, and
is making available for public review, according to the Fund Board’s policies
and practices on disclosure of information, a regular collection and analysis
of performance data of Fund grants, which shall cover both Principal Recipients
and sub-recipients.</text>
</clause><clause id="H639BAFD2A8AA41CD95B16E01499976B"><enum>(ii)</enum><text display-inline="yes-display-inline">A well-staffed, independent Office of the
Inspector General reports directly to the Board and is responsible for regular,
publicly published audits of both financial and programmatic and reporting
aspects of the Fund, its grantees, and LFAs, including both Principal
Recipients and sub-recipients.</text>
</clause><clause id="HD22E4844EEFF46FC95C8BBFEDA53AAFB"><enum>(iii)</enum><text>The Fund
Secretariat has established and is reporting publicly on standard indicators
for all program areas.</text>
</clause><clause id="H1575C1D7266646D58B59A87CBDC45CBD"><enum>(iv)</enum><text>The
Fund Secretariat has established a database that tracks all subrecipients and
the amounts of funds disbursed to each, as well as the distribution of
resources, by grant and Principal Recipient, for prevention, care, treatment,
the purchases of drugs and commodities, and other purposes.</text>
</clause><clause id="H61A78A1A25664DF0B1B508D63BD83729"><enum>(v)</enum><text>The
Fund Board has established a penalty to offset tariffs imposed by national
governments on all goods and services provided by the Fund.</text>
</clause><clause id="H97BF53972B2846D39D825FC5C64BFB4"><enum>(vi)</enum><text>The
Fund Board has successfully terminated its Administrative Services Agreement
with the World Health Organization and completed the Fund Secretariat’s
transition to a fully independent status under the Headquarters Agreement the
Fund has established with the Government of Switzerland.</text>
</clause></subparagraph><subparagraph id="H4CCA91E03CFC4EAB9464C9B700BBD297"><enum>(B)</enum><text display-inline="yes-display-inline">Support for the Global Fund to Fight AIDS,
Tuberculosis and Malaria should be based upon achievement of the following
benchmarks related to the founding principles of the Fund:</text>
<clause id="H55BBDFFFA2114D6C9D8F1415544C2B84"><enum>(i)</enum><text>The
Fund must maintain its status as a financing institution.</text>
</clause><clause id="H37FD1A0CFB81463994CC27C7E37D65E4"><enum>(ii)</enum><text>The
Fund must remain focused on programs directly related to HIV/AIDS, malaria, and
tuberculosis.</text>
</clause><clause id="HF2819909BC9A4AF7A03282CEB3978D90"><enum>(iii)</enum><text>The Fund must
maintain its Comprehensive Funding Policy, which requires confirmed pledges to
cover the full amount of new grants before the Board approves them.</text>
</clause><clause id="H90A5866D3F9743BF9C19504D4B049361"><enum>(iv)</enum><text>The
Fund must maintain and make progress on sustaining its multisectoral approach,
through Country Coordinating Mechanisms (CCMs) and in the implementation of
grants, as reflected in percent and resources allocated to different sectors,
including governments, civil society, and faith- and community-based
organizations.</text>
</clause></subparagraph></paragraph><paragraph id="H5D01E004B305486EA6A711FCCE86FA9"><enum>(4)</enum><header>Sense of
Congress</header><text>Congress—</text>
<subparagraph id="H5A60483139EC424FA1AF99B8FDC692B6"><enum>(A)</enum><text>notes that section
625 of <external-xref legal-doc="public-law" parsable-cite="pl/110/161">Public Law 110–161</external-xref> establishes a requirement to withhold 20 percent of
funds appropriated for the Global Fund if the Global Fund fails to meet certain
benchmarks; and</text>
</subparagraph><subparagraph id="H38AD774047C748ACAF76130095A98D3"><enum>(B)</enum><text>will continue to
review the implementation of the benchmarks to ensure accountability and
transparency of the Global Fund.</text>
</subparagraph></paragraph></subsection></section><section id="H1096F8538CC44449AC1B007BFD6368CB"><enum>203.</enum><header>Voluntary
contributions to international vaccine funds</header>
<subsection id="H914BE5C71A864CF1995DA45063327017"><enum>(a)</enum><header>Vaccine
Fund</header><text display-inline="yes-display-inline">Subsection (k) of
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
by striking <quote>fiscal years 2004 through 2008</quote> and inserting
<quote>fiscal years 2009 through 2013</quote>.</text>
</subsection><subsection commented="no" id="H1E675B0F3DD549F38828006D4DE79E6B"><enum>(b)</enum><header>International
AIDS Vaccine Initiative</header><text display-inline="yes-display-inline">Subsection (l) of such section is amended
by striking <quote>fiscal years 2004 through 2008</quote> and inserting
<quote>fiscal years 2009 through 2013</quote>.</text>
</subsection><subsection id="HDE309914CE9E4089BF998FE8B653B4C8"><enum>(c)</enum><header>Malaria vaccine
development programs</header><text display-inline="yes-display-inline">Subsection (m) of such section is amended
by striking <quote>fiscal years 2004 through 2008</quote> and inserting
<quote>fiscal years 2009 through 2013</quote>.</text>
</subsection><subsection id="HE5C247A40C0B4FD1A534D9D64FA5EBDE"><enum>(d)</enum><header>Research and
development of a tuberculosis vaccine</header><text display-inline="yes-display-inline">Such section is further amended by adding
at the end the following:</text>
<quoted-block display-inline="no-display-inline" id="H9D428C7A44854220BCECADB4E925D785" style="OLC">
<subsection id="HFFACF82BF8C947998376C9CACC93B6FE"><enum>(n)</enum><text display-inline="yes-display-inline">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 to
be available for United States contributions to research and development of a
tuberculosis
vaccine.</text>
</subsection><after-quoted-block>.</after-quoted-block></quoted-block>
</subsection></section><section display-inline="no-display-inline" id="HCED5CE619DDF4FECAEC195469519A328"><enum>204.</enum><header>Program to
facilitate availability of microbicides to prevent transmission of HIV and
other diseases</header>
<subsection id="H543B8F75146E46B4B6EB3D790817A500"><enum>(a)</enum><header>Statement of
policy</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="H0C36E1010D284FFCAD004264EF27F909"><enum>(b)</enum><header>Program
authorized</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, shall develop and implement a program to facilitate wide-scale
availability of microbicides that prevent the transmission of HIV after such
microbicides are proven safe and effective.</text>
</subsection><subsection id="H6183E1FE299A4881AFAA67F619ACC0B6"><enum>(c)</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
section.</text>
</subsection></section><section id="H9E6AFF464F7C4E889E63B4DB5F3FF3E3"><enum>205.</enum><header>
Plan to combat HIV/AIDS, tuberculosis, and malaria by strengthening health
policies and health systems of host countries</header>
<subsection id="HDB4AD64242BF4B71A82FD43DCDADF844"><enum>(a)</enum><header>In
general</header><text display-inline="yes-display-inline">Title II of the
United States Leadership Against HIV/AIDS, Tuberculosis, and Malaria Act of
2003 (<external-xref legal-doc="usc" parsable-cite="usc/22/7621">22 U.S.C. 7621 et seq.</external-xref>) is amended by adding at the end the
following:</text>
<quoted-block display-inline="no-display-inline" id="HA19C793D633648C4B1F27C5ECF8547FD" style="OLC">
<section id="H63BA9F1DF952488AB87BDC4DD6913CC7"><enum>204.</enum><header>Plan to combat
HIV/AIDS, tuberculosis, and malaria by strengthening health policies and health
systems of host countries</header>
<subsection id="H800ACBA5776043F5805E6D4CAABFA394"><enum>(a)</enum><header>Findings</header><text display-inline="yes-display-inline">Congress makes the following
findings:</text>
<paragraph id="H7E318BB759FB4D5A8C37F4AEA0A9DE19"><enum>(1)</enum><text display-inline="yes-display-inline">One of the most significant barriers to
achieving universal access to HIV/AIDS treatment and prevention in developing
countries is the lack of health infrastructure, particularly in sub-Saharan
Africa.</text>
</paragraph><paragraph id="HCAEE4A50F1494F6994F0BAB7FA27E2BD"><enum>(2)</enum><text display-inline="yes-display-inline">In addition to HIV/AIDS programs, other
treatable and preventable infectious diseases could be treated concurrently and
easily if health care delivery systems in developing countries were
significantly improved.</text>
</paragraph><paragraph commented="no" id="H49F70C54EDB345738E001BE8B3DBA49F"><enum>(3)</enum><text>More public
investment in basic primary health care should be a priority in public spending
in developing countries.</text>
</paragraph></subsection><subsection id="H20A55F0A312742D68185574403C177B"><enum>(b)</enum><header>Statement of
policy</header><text>It shall be the policy of the United States
Government—</text>
<paragraph id="H6FF61BE02A554CC4BC500000CB3716B"><enum>(1)</enum><text>to invest
appropriate resources authorized under this Act and the amendments made by this
Act to carry out activities to strengthen HIV/AIDS health policies and health
systems and provide workforce training and capacity-building consistent with
the goals and objectives of this Act and the amendments made by this Act;
and</text>
</paragraph><paragraph id="H644C8FD19F574F05A0339261B7627CA7"><enum>(2)</enum><text display-inline="yes-display-inline">to support the development of a sound
policy environment in host countries to increase the ability of such countries
to maximize utilization of health care resources from donor countries, deliver
services to the people of such host countries in an effective and efficient
manner, and reduce barriers that prevent recipients of services from achieving
maximum benefit from such services.</text>
</paragraph></subsection><subsection commented="no" id="H0F170BB7CF814F95836FB5FD4E299FC2"><enum>(c)</enum><header>Plan
required</header><text display-inline="yes-display-inline">The Coordinator of
United States Government Activities to Combat HIV/AIDS Globally, in
collaboration with the Administrator of the United States Agency for
International Development, shall develop and implement a plan to combat
HIV/AIDS by strengthening health policies and health systems of host countries
as part of the United States Agency for International Development’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 host countries,
particularly in Africa, in collaboration with United States postsecondary
educational institutions, 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><subsection commented="no" id="H895759A431FD481989529128ABC64B9D"><enum>(d)</enum><header>Assistance To
improve public finance management systems</header>
<paragraph display-inline="no-display-inline" id="H40E1251EE10E408D9BCAED4B466701FB"><enum>(1)</enum><header>In
general</header><text>The Secretary of the Treasury, acting through the head of
the Office of Technical Assistance, is authorized to provide assistance for
advisors and host country finance, health, and other relevant ministries to
improve the effectiveness of public finance management systems in host
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="H02F294779B7F43D59FCB4CB68C05DA1"><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></section><after-quoted-block>.</after-quoted-block></quoted-block>
</subsection><subsection id="HB13D03303EE54336BCE847B2BD3B9741"><enum>(b)</enum><header>Clerical
amendment</header><text display-inline="yes-display-inline">The table of
contents for the United States Leadership Against HIV/AIDS, Tuberculosis, and
Malaria Act of 2003 (<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 the following:</text>
<quoted-block display-inline="no-display-inline" id="HC3A5DDE7C5CE4C30BC1D70A9BEE13052" style="OLC">
<toc regeneration="no-regeneration">
<toc-entry level="section">Sec. 204. Plan to combat HIV/AIDS by
strengthening health policies and health systems of host
countries.</toc-entry>
</toc>
<after-quoted-block>.</after-quoted-block></quoted-block>
</subsection></section><enum>III</enum><header>Bilateral
efforts</header>
<subtitle id="HD3BD73F540EB42A2943BAEF0004089BB"><enum>A</enum><header>General assistance
and programs</header>
<section id="H096B03C8E6734EB7B8D440ADB700D634"><enum>301.</enum><header>Assistance to
combat HIV/AIDS</header>
<subsection id="H9052EAEFF1BF4C0AA338ED88B1648511"><enum>(a)</enum><header>Amendments to
the Foreign Assistance Act of 1961</header>
<paragraph id="HE48EB8CC97F741F7AFD65089987C141"><enum>(1)</enum><header>Finding</header><text display-inline="yes-display-inline">Subsection (a) of section 104A 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>) is amended by inserting
<quote>, South and Southeast Asia, Central and Eastern Europe</quote> after
<quote>the Caribbean</quote>.</text>
</paragraph><paragraph commented="no" id="H24B1201C0AC04EF08709E2DA47337F8D"><enum>(2)</enum><header>Policy</header><text>Subsection
(b) of such section is amended—</text>
<subparagraph id="HF3F2657EE7C547548E60CA30F96DF4"><enum>(A)</enum><text>in the first
sentence—</text>
<clause id="HD3C85ADC837C4660B0D575177EEFBB02"><enum>(i)</enum><text>by
striking <quote>It is a major</quote> and inserting the following:</text>
<quoted-block display-inline="no-display-inline" id="H8AC74EE57FEF4F04B306FD1BB16CEDB5" style="OLC">
<paragraph id="HDC33CC9064794D57A48F57D101B21C77"><enum>(1)</enum><header>General
policy</header><text display-inline="yes-display-inline">It is a
major</text>
</paragraph><after-quoted-block>;</after-quoted-block></quoted-block>
</clause><clause id="HDF6D5DDC1E6C4414B74DA4AFED4DA58E"><enum>(ii)</enum><text>by
striking <quote>control</quote> and inserting <quote>care</quote>; and</text>
</clause><clause id="H81913BEC8DAB434999F2828149D7DB6"><enum>(iii)</enum><text>by
adding at the end before the period the following: <quote>and to fulfill United
States commitments to move toward the goal of universal access to prevention,
treatment, and care of HIV/AIDS</quote>;</text>
</clause></subparagraph><subparagraph id="HABE1D57039534547998F3EBBB76A098"><enum>(B)</enum><text>by adding at the
end the following: <quote>The United States and other developed countries
should provide assistance for the prevention, treatment, and care of HIV/AIDS
to countries in sub-Saharan Africa, the Caribbean, South and Southeast Asia and
Central and Eastern Europe, addressing both generalized epidemics and epidemics
concentrated among populations at high risk of infection.</quote>; and</text>
</subparagraph><subparagraph id="H996BC440AFD541B0BFFF473046EC4D9F"><enum>(C)</enum><text>by further adding
at the end the following:</text>
<quoted-block display-inline="no-display-inline" id="H5481A7C4F3554092A6D081BBCF1B8F" style="OLC">
<paragraph id="H906B24BFF91A46D381CE0295BD5F929"><enum>(2)</enum><header>Specific
policy</header><text display-inline="yes-display-inline">It is therefore the
policy of the United States, by 2013, to—</text>
<subparagraph id="HAAA63AA4B7EF4FA0A2389F58F4D553F0"><enum>(A)</enum><text>prevent 12,000,000
new HIV infections worldwide;</text>
</subparagraph><subparagraph id="H3EAA262C1D3E4BCDB2863409A9000844"><enum>(B)</enum><text>support treatment
of at least 3,000,000 individuals with HIV/AIDS with the goal of treating
450,000 children;</text>
</subparagraph><subparagraph id="HA1BDEFA2329842B6A61106EDD500D59F"><enum>(C)</enum><text display-inline="yes-display-inline">provide care for 12,000,000 individuals
affected by HIV/AIDS, including 5,000,000 orphans and vulnerable children in
communities affected by HIV/AIDS, including orphans with HIV/AIDS; and</text>
</subparagraph><subparagraph id="H8CC8736C96434452BA23C0A24517B7EE"><enum>(D)</enum><text>train at least
140,000 new health care professionals and workers for HIV/AIDS prevention,
treatment and
care.</text>
</subparagraph></paragraph><after-quoted-block>.</after-quoted-block></quoted-block>
</subparagraph></paragraph><paragraph id="H000306E7E1C14076BA4870F93D595755"><enum>(3)</enum><header>Authorization</header><text>Subsection
(c) of such section is amended—</text>
<subparagraph id="H823D12337E7C4C7EB4DA46129287614D"><enum>(A)</enum><text display-inline="yes-display-inline">in paragraph (1)—</text>
<clause id="H90FEE98C281C4944B44CF228E3D59C39"><enum>(i)</enum><text>by
inserting <quote>, South and Southeast Asia, Central and Eastern Europe</quote>
after <quote>the Caribbean</quote>; and</text>
</clause><clause id="HF260D2474CEA47D100FDCE3600132620"><enum>(ii)</enum><text>by
adding at the end before the period the following: <quote>, and particularly
with respect to refugee populations in such countries and areas</quote>;</text>
</clause></subparagraph><subparagraph id="H299C5FF437714DF1BE87689281CB906E"><enum>(B)</enum><text>in paragraph
(2)—</text>
<clause id="HFA9CA5C56AFA4F209419CF6F5D45167F"><enum>(i)</enum><text>by
inserting <quote>, South and Southeast Asia, Central and Eastern Europe</quote>
after <quote>the Caribbean</quote>; and</text>
</clause><clause id="H043A657D19234E95ABC920435909D5A9"><enum>(ii)</enum><text>by
adding at the end before the period the following: <quote>, and particularly
with respect to refugee populations in such countries and areas</quote>;</text>
</clause></subparagraph><subparagraph id="HA0D331A21ED147598EBA99D998AEB54D"><enum>(C)</enum><text>by redesignating
paragraph (3) as paragraph (4);</text>
</subparagraph><subparagraph id="H25D2CA8A31BB4FECB780F23FEF16BEA"><enum>(D)</enum><text>by inserting after
paragraph (2) the following:</text>
<quoted-block display-inline="no-display-inline" id="HE324173CD63843078694812F15F76FED" style="OLC">
<paragraph commented="no" id="HDD5A1C0CD2354AA1BBE13BDFBE511DB"><enum>(3)</enum><header>Role of public
health care delivery systems</header><text display-inline="yes-display-inline">It is the sense of Congress that—</text>
<subparagraph id="H9AC8BEE0E859493D84EECB759EBA5DB9"><enum>(A)</enum><text>the President
should provide an appropriate level of assistance under paragraph (1) to help
strengthen public health care delivery systems financed by host countries;
and</text>
</subparagraph><subparagraph id="H907DC15853AA464EA45F8925AB4F2EF3"><enum>(B)</enum><text>the President,
acting through the Coordinator of United States Government Activities to Combat
HIV/AIDS Globally, should support the development of a policy framework in such
host countries for the long-term sustainability of HIV/AIDS prevention,
treatment, and care programs, and for strengthening health care delivery
systems and increasing health workforces through recruitment, training, and
policies that allows the devolution of clinical responsibilities to increase
the work force able to deliver prevention, treatment, and care services, as
necessary, with clearly identified objectives and reporting strategies for such
services.</text>
</subparagraph></paragraph><after-quoted-block>;</after-quoted-block></quoted-block>
</subparagraph><subparagraph id="H08F5169CB0E542E18F4DC86F7A0F105"><enum>(E)</enum><text>in paragraph (4)
(as redesignated by subparagraph (C) of this paragraph), by striking
<quote>foreign countries</quote> and inserting <quote>host countries and donor
countries</quote>; and</text>
</subparagraph><subparagraph id="HB3D494A0DFEF49F6A7C800D5DCA25786"><enum>(F)</enum><text>by adding at the
end the following:</text>
<quoted-block display-inline="no-display-inline" id="HF059FD3FA8E64C8C00F249A6CE0870F2" style="OLC">
<paragraph commented="no" id="H16669505E0574A3784E6C52F34DD5C"><enum>(5)</enum><header>Sense of
Congress</header>
<subparagraph id="H576899F048A64D09A27310133B051145"><enum>(A)</enum><header>In
general</header><text>It is the sense of Congress that the Coordinator of
United States Government Activities to Combat HIV/AIDS Globally and the heads
of relevant executive branch agencies (as such term is defined in section 3 of
the United States Leadership Against HIV/AIDS, Tuberculosis, and Malaria Act of
2003) should operate in a manner consistent with the <quote>Three Ones</quote>
goals of UNAIDS.</text>
</subparagraph><subparagraph id="H7B0F88684ADB4B068C870061A51D6993"><enum>(B)</enum><header><quote>Three
ones</quote> goals of UNAIDS defined</header><text>In this paragraph, the term
<term><quote>Three Ones</quote> goals of UNAIDS</term> means—</text>
<clause id="H8FA745BDC4A746A5A9B97004EB488C00"><enum>(i)</enum><text>the goal of one
agreed HIV/AIDS action framework that provides the basis for coordinating the
work of all partners in host countries;</text>
</clause><clause id="H2A23B29276CF4E488E1D9DD9079584D7"><enum>(ii)</enum><text>the goal of one
national HIV/AIDS coordinating authority, with a broad-based multisectoral
mandate; and</text>
</clause><clause id="H2AD2F6DC09AA4C39AB52AF036C47BB9E"><enum>(iii)</enum><text>the goal of one
agreed country-level data-collection, monitoring, and evaluation
system.</text>
</clause></subparagraph></paragraph><after-quoted-block>.
</after-quoted-block></quoted-block>
</subparagraph></paragraph><paragraph id="H57971D17C6034FA1A8DD6C0076F78C26"><enum>(4)</enum><header>Activities
supported</header>
<subparagraph id="HA336468E622E4B24B463ADBB4F03A7C"><enum>(A)</enum><header>Prevention</header><text>Subsection
(d)(1) of such section is amended—</text>
<clause id="HC95A4C1B8A9A43DB8DA084D571A2FFA2"><enum>(i)</enum><text display-inline="yes-display-inline">in subparagraph (A)—</text>
<subclause id="H6188BCA4B0614D68BCB68C8EE807C569"><enum>(I)</enum><text>by inserting
<quote>efforts by faith-based and other nongovernmental organizations
and</quote> after <quote>infection, including</quote>;</text>
</subclause><subclause id="HE480D2AD53684A2CBFCFDA9D499B7D00"><enum>(II)</enum><text>by inserting
<quote>, including access to such programs and efforts in family planning
programs supported by the United States Government,</quote> after <quote>health
programs</quote>; and</text>
</subclause><subclause id="H7B594D8599B5466FA4641B8E9FAEC0D2"><enum>(III)</enum><text>by inserting
<quote>male and female</quote> before <quote>condoms</quote>;</text>
</subclause></clause><clause id="H27DFCA24FF0F419B8F15B30789AB1066"><enum>(ii)</enum><text display-inline="yes-display-inline">in subparagraph (B)—</text>
<subclause id="HB1D45E2B21CB4C12A8D81FBBDFD09E4D"><enum>(I)</enum><text>by inserting
<quote>relevant and</quote> after <quote>culturally</quote>;</text>
</subclause><subclause id="H15DDD6434C67446A8BFB34E0A0EB8C75"><enum>(II)</enum><text>by inserting
<quote>and programs</quote> after <quote>those organizations</quote>;
and</text>
</subclause><subclause id="HA2E2F77364CF432AB2A81E493C76A235"><enum>(III)</enum><text>by inserting
<quote>, level of scientific and fact-based knowledge</quote> after
<quote>experience</quote>;</text>
</subclause></clause><clause id="HA345088A04294F88006ECD00845C7700"><enum>(iii)</enum><text display-inline="yes-display-inline">in subparagraph (D), by inserting
<quote>and nonjudgmental approaches</quote> after
<quote>protections</quote>;</text>
</clause><clause commented="no" id="HDAD61FBA762848CDBF28F29D76B8033F"><enum>(iv)</enum><text display-inline="yes-display-inline">by amending subparagraph (E) to read as
follows:</text>
<quoted-block display-inline="no-display-inline" id="H7C510E3017874C0598C87023DFCBFE7E" style="OLC">
<subparagraph commented="no" id="H8022B63772F042CE8260A87D526BB1BE"><enum>(E)</enum><text display-inline="yes-display-inline">assistance to achieve the target 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, as described in section 312(b)(1) of
the United States Leadership Against HIV/AIDS, Tuberculosis, and Malaria Act of
2003, and to promote infant feeding options that meet the criteria described in
the World Health Organization’s Global Strategy for Infant and Young Child
Feeding;</text>
</subparagraph><after-quoted-block>;</after-quoted-block></quoted-block>
</clause><clause id="H6B06A34F7CC340DBB37F50CEED5DC643"><enum>(v)</enum><text>in
subparagraph (G)—</text>
<subclause id="H2FC1C1837D1E48E899AEF7CDF34CE020"><enum>(I)</enum><text display-inline="yes-display-inline">by adding at the end before the semicolon
the following: <quote>, including education and services demonstrated to be
effective in reducing the transmission of HIV infection without increasing
illicit drug use</quote>; and</text>
</subclause><subclause id="H0E9312637A8F4831B2FCA430DEAE10DE"><enum>(II)</enum><text>by striking
<quote>and</quote> at the end;</text>
</subclause></clause><clause id="H9EC35E89136F48CFBB9D63C406A8F4AA"><enum>(vi)</enum><text>in
subparagraph (H), by striking the period at the end and inserting <quote>;
and</quote>; and</text>
</clause><clause commented="no" id="HA3B42C840ED14AC000398419EC87C000"><enum>(vii)</enum><text>by adding at the
end the following:</text>
<quoted-block display-inline="no-display-inline" id="HC58A53D8740449AFB14266D324C024E0" style="OLC">
<subparagraph commented="no" id="H44F38044738B461F87B75B8377E4E9B2"><enum>(I)</enum><clause commented="no" display-inline="yes-display-inline" id="H8DF74F4124E54B0D8816FE35FB4D5F1E"><enum>(i)</enum><text>assistance for
counseling, testing, treatment, care, and support programs for prevention of
re-infection of individuals with HIV/AIDS;</text>
</clause><clause commented="no" id="HC45D8C356A514C2EB7306BF06FE4F63D" indent="up1"><enum>(ii)</enum><text>counseling to prevent sexual
transmission of HIV, including skill development for practicing abstinence,
reducing the number of sexual partners, and providing information on correct
and consistent use of male and female condoms;</text>
</clause><clause commented="no" id="H943817424EB54D3AA94042D93D274429" indent="up1"><enum>(iii)</enum><text>assistance to provide male and
female condoms;</text>
</clause><clause commented="no" id="HE2FF452FBB1442358FCCCB54A26601E" indent="up1"><enum>(iv)</enum><text>diagnosis and treatment of other
sexually-transmitted infections;</text>
</clause><clause commented="no" id="H6A4B1E1A329346E888754EE5EA975EDC" indent="up1"><enum>(v)</enum><text>strategies to address the stigma
and discrimination that impede HIV/AIDS prevention efforts; and</text>
</clause><clause id="H39B5DEDCB4CA4948860015F55997EB00" indent="up1"><enum>(vi)</enum><text display-inline="yes-display-inline">assistance to facilitate widespread access
to microbicides for HIV prevention, as 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
post-introduction monitoring; and</text>
</clause></subparagraph><subparagraph id="HAAFF22C919994FEFA3D2341C86FF3D4E"><enum>(J)</enum><text display-inline="yes-display-inline">assistance for HIV/AIDS education targeted
to reach and prevent the spread of HIV among men who have sex with
men.</text>
</subparagraph><after-quoted-block>.</after-quoted-block></quoted-block>
</clause></subparagraph><subparagraph id="H0329D5842AE64821AE82004BBCF4714"><enum>(B)</enum><header>Treatment</header><text display-inline="yes-display-inline">Subsection (d)(2) of such section is
amended—</text>
<clause id="HF20E2718612747FA96BB68D463F9D060"><enum>(i)</enum><text>in
subparagraph (B), by striking <quote>; and</quote> at the end and inserting a
semicolon;</text>
</clause><clause id="H1EFC3CF522D34768B2305626B47DB5D3"><enum>(ii)</enum><text>in
subparagraph (C), by striking the period at the end and inserting a semicolon;
and</text>
</clause><clause commented="no" id="H16DED62D2E3448BB9BA5AB0359E946F2"><enum>(iii)</enum><text>by adding at the
end the following:</text>
<quoted-block display-inline="no-display-inline" id="H57741CAC510541DD85BEC83500FCEB64" style="OLC">
<subparagraph commented="no" id="H19FED2C670314BADA0DC4CEF200FBA4"><enum>(D)</enum><text display-inline="yes-display-inline">assistance specifically to address barriers
that might limit the start of and adherence to treatment services, especially
in rural areas, through such measures as mobile and decentralized distribution
of treatment services, and where feasible and necessary, direct linkages with
nutrition, safe drinking water, and income security programs, referrals to
services for victims of violence, support groups for individuals with HIV/AIDS,
and efforts to combat stigma and discrimination against all such
individuals;</text>
</subparagraph><subparagraph id="H37E11709F25C4FA69622D39C7859311D"><enum>(E)</enum><text>assistance to
support comprehensive HIV/AIDS treatment (including free prophylaxis and
treatment for common HIV/AIDS-related opportunistic infections) for at least
one-third of individuals with HIV/AIDS in the poorest countries worldwide who
are in clinical need of antiretroviral treatment; and</text>
</subparagraph><subparagraph id="H56698BFBF9D64459A8E991A7FEB51982"><enum>(F)</enum><text>assistance to
improve access to psychosocial support systems and other necessary services for
youth who are infected with HIV to ensure the start of and adherence to
treatment
services.</text>
</subparagraph><after-quoted-block>.</after-quoted-block></quoted-block>
</clause></subparagraph><subparagraph id="HF2C039FD580246CCB576C83FDDA2A397"><enum>(C)</enum><header>Monitoring</header><text display-inline="yes-display-inline">Subsection (d)(4) of such section is
amended—</text>
<clause id="H716287C6B0714F138E94291F05932E68"><enum>(i)</enum><text>by
striking <quote>The monitoring</quote> and inserting the following:</text>
<quoted-block display-inline="no-display-inline" id="H6EDF00C4B3B949CFBB747C006F7D9B72" style="OLC">
<subparagraph id="H24FF65137AF84B55B811108CFC416315"><enum>(A)</enum><header>In
general</header><text display-inline="yes-display-inline">The
monitoring</text>
</subparagraph><after-quoted-block>;</after-quoted-block></quoted-block>
</clause><clause id="H3F06A74203574743AED521E0C6002C5E"><enum>(ii)</enum><text display-inline="yes-display-inline">by inserting <quote>and paragraph
(8)</quote> after <quote>paragraphs (1) through (3)</quote>;</text>
</clause><clause id="HC4BA422C9CB54CB9ACA7B787D82C13A3"><enum>(iii)</enum><text>by
redesignating subparagraphs (A) through (D) as clauses (i) through (iv),
respectively;</text>
</clause><clause id="HBE8C05A1AD3942CAA098ED6FE3AE302F"><enum>(iv)</enum><text>in
clause (iii) (as redesignated by clause (iii) of this subparagraph), by
striking <quote>and</quote> at the end;</text>
</clause><clause id="H008665B6787E459DBA38ACB3637087F9"><enum>(v)</enum><text display-inline="yes-display-inline">in clause (iv) (as redesignated by clause
(iii) of this subparagraph), by striking the period at the end and inserting
<quote>; and</quote>;</text>
</clause><clause commented="no" id="HDC180CE6EF0845989BE6DDBB49D4C331"><enum>(vi)</enum><text>by adding at the
end the following:</text>
<quoted-block display-inline="no-display-inline" id="HCD44492B096140909FE21CEC99BAF7D6" style="OLC">
<clause commented="no" id="H0BFD9B98BF9D403583B031FFC93BF552"><enum>(v)</enum><text display-inline="yes-display-inline">carrying out and expanding program
monitoring, impact evaluation research, and operations research (including
research and evaluations of gender-responsive interventions, disaggregated by
age and sex, in order to identify and replicate effective models, develop
gender indicators to measure both outcomes and impacts of interventions,
especially interventions designed to reduce gender inequalities, and collect
lessons learned for dissemination among different countries) in order
to—</text>
<subclause display-inline="no-display-inline" id="H77F43A4D62AE4A74B18D7ED0D0B4D3A7"><enum>(I)</enum><text>improve the
coverage, efficiency, effectiveness, quality and accessibility of services
provided under this section;</text>
</subclause><subclause id="H2EFE8E3382134B78A7CD6E1D00E403EF"><enum>(II)</enum><text>establish the
cost-effectiveness of program models;</text>
</subclause><subclause id="HEE1F02D09C9B4F2FB40060CA8600FBF8"><enum>(III)</enum><text>assess the
population-level impact of programs, projects, and activities
implemented;</text>
</subclause><subclause id="H12C46DD57F8F47C2A098CDEF72A179E1"><enum>(IV)</enum><text>ensure the
transparency and accountability of services provided under this section;</text>
</subclause><subclause id="HB884C606D3B4458BB756E53BEE519B2B"><enum>(V)</enum><text>disseminate and
promote the utilization of evaluation findings, lessons, and best practices in
the implementation of programs, projects, and activities supported under this
section; and</text>
</subclause><subclause id="H5A7F28544BC548C0A9174DF91E35E04E"><enum>(VI)</enum><text>encourage and
evaluate innovative service models and strategies to optimize functionality of
programs, projects, and activities.</text>
</subclause></clause><after-quoted-block>;
and</after-quoted-block></quoted-block>
</clause><clause id="HDF99C5328248407C8F84815EACC589B8"><enum>(vii)</enum><text>by
further adding at the end the following:</text>
<quoted-block display-inline="no-display-inline" id="H3D85DDD69F704572B9482ED16486C67" style="OLC">
<subparagraph commented="no" id="H25B5610BE75E4CB6B18D45BDA3D14D88"><enum>(B)</enum><header>Definitions</header><text display-inline="yes-display-inline">For purposes of subparagraph (A)(v)—</text>
<clause commented="no" id="HB627A2F6257D4E7FBD53241F173FE2AD"><enum>(i)</enum><text display-inline="yes-display-inline">the term <term>impact evaluation
research</term> means the application of research methods and statistical
analysis to measure the extent to which a change in a population-based outcome
can be attributed to a program, project, or activity as opposed to other
factors in the environment;</text>
</clause><clause commented="no" id="HCAEDFD89AEE34070AA00F6A0F1F008A3"><enum>(ii)</enum><text display-inline="yes-display-inline">the term <term>program monitoring</term>
means the collection, analysis, and use of routine data with respect to a
program, project, or activity to determine how well the program, project, or
activity is carried out and at what cost; and</text>
</clause><clause commented="no" id="H3EB8C968C4684F6D83405B45B193D58"><enum>(iii)</enum><text display-inline="yes-display-inline">the term <term>operations research</term>
means the application of social science research methods and statistical
analysis to judge, compare, and improve policy outcomes and outcomes of a
program, project, or activity, from the earliest stages of defining and
designing the program, project, or activity through the development and
implementation of the program, project, or
activity.</text>
</clause></subparagraph><after-quoted-block>.</after-quoted-block></quoted-block>
</clause></subparagraph><subparagraph id="HF4E769EA846B4F058279078F084785B4"><enum>(D)</enum><header>Pharmaceuticals</header><text display-inline="yes-display-inline">Subsection (d)(5) of such section is
amended—</text>
<clause id="H7BD9B58F1FE74ABBA120FD33008DA310"><enum>(i)</enum><text>by
redesignating subparagraph (C) as subparagraph (D); and</text>
</clause><clause id="H2471EEA52A5848559D00B694978B22FB"><enum>(ii)</enum><text>by
inserting after subparagraph (B) the following:</text>
<quoted-block display-inline="no-display-inline" id="HE6F64D9C16184CE58D9BD6E291005F91" style="OLC">
<subparagraph id="H3C6A0000B7014156A5CEE618EE00D1AA"><enum>(C)</enum><header>Mechanisms to
ensure cost-effective drug purchasing</header><text display-inline="yes-display-inline">Mechanisms to ensure that 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.</text>
</subparagraph><after-quoted-block>.</after-quoted-block></quoted-block>
</clause></subparagraph><subparagraph commented="no" id="H4730E324691D48A6ABED77963BEFD3E7"><enum>(E)</enum><header>Referral systems
and coordination with other assistance programs</header>
<clause id="HC4BFE2E0B83F418BAD68D4E9B46E38B1"><enum>(i)</enum><header>Finding</header><text display-inline="yes-display-inline">The effectiveness of all HIV/AIDS
prevention, treatment, and care programs and the survival of individuals with
HIV/AIDS would be enhanced by ensuring that such individuals are referred to
appropriate support programs, including education, income generation, HIV/AIDS
support group and food and nutrition programs, and by providing assistance
directly to such programs to the extent such programs would further the
purposes of expanding access to and the success of HIV/AIDS prevention,
treatment, and care.</text>
</clause><clause id="HC7F4994E563D455EA0FFD9AD4885F2D0"><enum>(ii)</enum><header>Amendment</header><text>Subsection
(d) of such section is further amended by adding at the end the
following:</text>
<quoted-block display-inline="no-display-inline" id="HECF58089B5D8469689ABD8A405E866D1" style="OLC">
<paragraph commented="no" id="H14E6FEFA7F41401B8900919F6CBB3066"><enum>(8)</enum><header>Referral systems
and coordination with other assistance programs</header>
<subparagraph commented="no" id="H6E804080874F410C84C41B4273CAD00"><enum>(A)</enum><header>Referral
systems</header><text>Assistance to ensure that a continuum of care is
available to individuals participating in HIV/AIDS prevention, treatment, and
care programs through the development of referral systems for such individuals
to community-based programs that, where practicable, are co-located with such
HIV/AIDS programs, and that provide support activities for such individuals,
including HIV/AIDS treatment adherence, HIV/AIDS support groups, food and
nutrition support, maternal health services, substance abuse prevention and
treatment services, income-generation programs, legal services, and other
program support.</text>
</subparagraph><subparagraph id="H7569ED5900954FBB8442C47513BD12D1"><enum>(B)</enum><header>Coordination
with other assistance programs</header>
<clause id="HAF4CEEA84EDE43C4BB4C33974C617ED3" indent="up1"><enum>(i)</enum><subclause commented="no" display-inline="yes-display-inline" id="HFEC68937F8EB48EB95F6955714D4F6EB"><enum>(I)</enum><text>Assistance to integrate
HIV/AIDS testing with testing for other easily detectable and treatable
infectious diseases, such as malaria, tuberculosis, and respiratory infections,
and to provide treatment if possible or referral to appropriate treatment
programs.</text>
</subclause><subclause id="HC34FBC07F59E42A68D424DF4B166F526" indent="up1"><enum>(II)</enum><text>Assistance to provide, whenever
possible, as a component of HIV/AIDS prevention, treatment, and care services,
and co-treatment of curable diseases, such as other sexually transmitted
diseases.</text>
</subclause><subclause id="H6A8F0031A2884F4D92A760351DE81B96" indent="up1"><enum>(III)</enum><text>Assistance and other activities
to ensure, through interagency and international coordination, that United
States global HIV/AIDS programs are integrated and complementary to delivering
related health services.</text>
</subclause></clause><clause id="HD9946C8103434F3193DE08F329B11376" indent="up1"><enum>(ii)</enum><text>Assistance to support schools and
related programs for children and youth that increase the effectiveness of
programs described in this subsection by providing the infrastructure,
teachers, and other support to such programs.</text>
</clause><clause id="HB98E5BFF21454362BA411F5CF7D8D991" indent="up1"><enum>(iii)</enum><text>Assistance and other activities
to provide access to HIV/AIDS prevention, treatment, and care programs in
family planning and maternal and child health programs supported by the United
States Government.</text>
</clause><clause id="H897F847078B6493C8289EEDF24A60097" indent="up1"><enum>(iv)</enum><text display-inline="yes-display-inline">Assistance to United States and host
country nonprofit development organizations that directly support livelihood
initiatives in HIV/AIDS-affected countries that provide opportunities for
direct lending to microentrepreneurs by United States citizens or opportunities
for United States citizens to purchase livestock and plants for families to
provide nutrition and generate income for individual households and
communities.</text>
</clause><clause id="H50727455CEF34A8A82E4B23181576BE3" indent="up1"><enum>(v)</enum><text>Assistance to coordinate and
provide linkages between HIV/AIDS prevention, treatment, and care programs with
efforts to improve the economic and legal status of women and girls.</text>
</clause><clause commented="no" id="H00C9C826D2E34265A209A73600928D00" indent="up1"><enum>(vi)</enum><text display-inline="yes-display-inline">Technical assistance coordinated across
implementing agencies, offered on a regular basis, and made available upon
request, for faith-based and community-based organizations, especially
indigenous organizations and new partners who do not have extensive experience
managing United States foreign assistance programs, including for training and
logistical support to establish financial mechanisms to track program receipts
and expenditures and data management systems to ensure data quality and
strengthen reporting.</text>
</clause><clause id="HEE086E790F1042069BAC73628B90CF20" indent="up1"><enum>(vii)</enum><text>In accordance with the World
Health Organization’s Interim Policy on TB/HIV Activities (2004), assistance to
individuals with or symptomatic of tuberculosis, and assistance to implement
the following:</text>
<subclause id="H8678462D134A40F7BBCE6F74E7774DD1"><enum>(I)</enum><text display-inline="yes-display-inline">Provide opt-out HIV/AIDS counseling and
testing and appropriate referral for treatment and care to individuals with or
symptomatic of tuberculosis, and work with host countries to ensure that such
individuals in host countries are provided such services.</text>
</subclause><subclause id="H59E94C93E1AC4519B13F2CDB4935184C"><enum>(II)</enum><text>Ensure, in coordination with host
countries, that individuals with HIV/AIDS receive tuberculosis screening and
other appropriate treatment.</text>
</subclause><subclause id="H7603D34DCABA44BE82AA8197F6D6B6C4"><enum>(III)</enum><text>Provide increased funding for HIV/AIDS
and tuberculosis activities, by increasing total resources for such activities,
including lab strengthening and infection control.</text>
</subclause><subclause id="HAE28A8500C2246C98918D3AE3999E498"><enum>(IV)</enum><text>Improve the management and dissemination
of knowledge gained from HIV/AIDS and tuberculosis activities to increase the
replication of best
practices.</text>
</subclause></clause></subparagraph></paragraph><after-quoted-block>.</after-quoted-block></quoted-block>
</clause></subparagraph></paragraph><paragraph id="H041E8703607A455A9813AAA400D6C48"><enum>(5)</enum><header>Annual
report</header><text>Subsection (e) of such section is amended—</text>
<subparagraph id="HE309E560D12B4EBE83B12C03BEEEA5B"><enum>(A)</enum><text>in paragraph (1),
by striking <quote>Committee on International Relations</quote> and inserting
<quote>Committee on Foreign Affairs</quote>;</text>
</subparagraph><subparagraph id="H5536598B806A4ABBBACB019BEFF8AEFD"><enum>(B)</enum><text>in paragraph
(2)—</text>
<clause id="HAAE98120CA5743BFBB4C98BFEEE7433"><enum>(i)</enum><text>in
subparagraph (B), by striking <quote>and</quote> at the end;</text>
</clause><clause id="H49F8E770DFE9434C9053008003DF96DB"><enum>(ii)</enum><text>in
subparagraph (C)—</text>
<subclause id="H0633D0BE1A23442684C96438F2D78CAF"><enum>(I)</enum><text>in the matter
preceding clause (i), by striking <quote>including</quote> and inserting
<quote>including—</quote>;</text>
</subclause><subclause commented="no" id="HCA48F05F528A42E39189B8114E6F7E4B"><enum>(II)</enum><text>by striking
clauses (i) and (ii) and inserting the following:</text>
<quoted-block id="H4C2659D319574A9100F24FCF5EC64CF3">
<clause commented="no" id="H1AD8ABB06A614F11B39D734E4D10CC4F"><enum>(i)</enum><subclause commented="no" display-inline="yes-display-inline" id="HBC1EA8FB44DB459891C18D56E9E805A0"><enum>(I)</enum><text>the effectiveness of
such programs in reducing the transmission of HIV, particularly in women and
girls, in reducing mother-to-child transmission of HIV, including through drug
treatment and therapies, either directly or by referral, and in reducing
mortality rates from HIV/AIDS, including through drug treatment, and addiction
therapies;</text>
</subclause><subclause id="HB35D87E17CBE4E7789DA2D4117C58D19" indent="up1"><enum>(II)</enum><text display-inline="yes-display-inline">a
description of strategies, goals, programs, and interventions to address the
specific needs and vulnerabilities of young women and young men; the progress
toward expanding access among young women and young men to evidence-based,
comprehensive HIV/AIDS health care services and HIV prevention and sexuality
and abstinence education programs at the individual, community, and national
levels; and clear targets for integrating adolescents who are orphans,
including adolescents who are infected with HIV, into programs for orphans and
vulnerable children; and</text>
</subclause><subclause id="H02C448A3E5814511BD85261700605F90" indent="up1"><enum>(III)</enum><text display-inline="yes-display-inline">the
amount of United States funding provided under the authorities of this Act to
procure drugs for HIV/AIDS programs in countries described in section
1(f)(2)(B)(IX) of the State Department Basic Authorities Act of 1956 (22 U.S.C.
2651a(f)(2)(B)(VIII)), including a detailed description of anti-retroviral
drugs procured, including—</text>
<item id="H5F4D1E60D7FD4B02A24BAC2F1E3E384C"><enum>(aa)</enum><text>the total amount expended for each
generic and name brand drug;</text>
</item><item id="H8952EA4DCCE34FEC9DF62B13FE4C10DF"><enum>(bb)</enum><text>the price paid per unit of each drug;
and</text>
</item><item id="H83BC18D0231F4EE00000F12D8E23E2B6"><enum>(cc)</enum><text>the vendor from which each drug was
purchased; and</text>
</item></subclause></clause><clause commented="no" id="HD70700DE6FE84F73B900DF993C23B8FD"><enum>(ii)</enum><text display-inline="yes-display-inline">the progress made toward improving health
care delivery systems (including the training of adequate numbers of health
care professionals) and infrastructure to ensure increased access to care and
treatment, including a description of progress toward—</text>
<subclause commented="no" id="H350AA39514F44493AE736346869E9824"><enum>(I)</enum><item commented="no" display-inline="yes-display-inline" id="HAB19DB84145A4C85BAC98C9DF7F4D35F"><enum>(aa)</enum><text>the training and
retention of adequate numbers of health care professionals in order to meet a
nationally-determined ratio of doctors, nurses, and midwives to patients, based
on the target of the 2.3 per-thousand ratio established by the World Health
Organization (WHO);</text>
</item><item id="H07F16825C8E6423B8684F22F4197B78B" indent="up1"><enum>(bb)</enum><text>increases in the number of other
health care professions, such as pharmacists and lab technicians, as necessary;
and</text>
</item><item id="H158716E133C74F5494005857AEA4BD81" indent="up1"><enum>(cc)</enum><text>the improvement of infrastructure
needed to ensure universal access to HIV/AIDS prevention, treatment, and care
by 2015;</text>
</item></subclause><subclause commented="no" id="HE205F6F9DDBC4B03B633EE4832C52071"><enum>(II)</enum><text display-inline="yes-display-inline">national health care workforce strategy
benchmarks, as required by section 202(d)(5)(B) of the United States Leadership
Against HIV/AIDS, Tuberculosis, and Malaria Act of 2003, United States
contributions to developing and implementing the benchmarks, and main
challenges to implementing the benchmarks;</text>
</subclause><subclause commented="no" id="H6E326ADBAA6F49499141764D7FFCAF53"><enum>(III)</enum><text>ensuring, to the
extent practicable, that health care workers providing services under this Act
have safe working conditions and are receiving health care services, including
services relating to HIV/AIDS;</text>
</subclause><subclause commented="no" id="H5E676216F4DB4E0C85D1C3ECFFB9105"><enum>(IV)</enum><text>activities to
strengthen health care systems in order to overcome obstacles and barriers to
the provision of HIV/AIDS, tuberculosis, and malaria services;</text>
</subclause><subclause commented="no" id="H6B335D5E3E2B4E079686A9E5D64068FE"><enum>(V)</enum><text>improving
integration and coordination of HIV/AIDS programs with related health care
services and supporting the capacity of health care programs to refer
individuals to community-based services; and</text>
</subclause><subclause commented="no" id="H7B2D5028E24E4018A4A570EA003BFBFB"><enum>(VI)</enum><text>strengthening
procurement and supply chain management systems of host
countries;</text>
</subclause></clause><after-quoted-block>;</after-quoted-block></quoted-block>
</subclause><subclause commented="no" id="H496E11946D964EF692FF7C00E2BA1B60"><enum>(III)</enum><text>in clause (iii),
by adding at the end before the semicolon the following: <quote>, including the
percentage of such United States foreign assistance provided for diagnosis and
treatment of individuals with tuberculosis in countries with the highest burden
of tuberculosis, as determined by the World Health Organization (WHO)</quote>;
and</text>
</subclause><subclause commented="no" id="H0EAFF9951DFA4CAC9F30BC1D05F3002F"><enum>(IV)</enum><text>in clause (iv),
by striking the period at the end and inserting a semicolon; and</text>
</subclause></clause><clause commented="no" id="HAF8138C71F0E45CEBB03E5D7147B0029"><enum>(iii)</enum><text display-inline="yes-display-inline">by adding at the end the following:</text>
<quoted-block display-inline="no-display-inline" id="H32DA76874241473DB3B5FB38F8DDA8C1" style="OLC">
<subparagraph commented="no" id="H3777A6CBC1894993A1808D77E1E33D9"><enum>(D)</enum><text display-inline="yes-display-inline">a description of efforts to integrate
HIV/AIDS and tuberculosis prevention, treatment, and care programs,
including—</text>
<clause commented="no" id="H5C9C77BC161E4F46ADD7A95B4B2B40A1"><enum>(i)</enum><text>the number and
percentage of HIV-infected individuals receiving HIV/AIDS treatment or care
services who are also receiving screening and subsequent treatment for
tuberculosis;</text>
</clause><clause commented="no" id="H5A262C05E61F4F93ABF845E5BF7356AF"><enum>(ii)</enum><text>the number and
percentage of individuals with tuberculosis who are receiving HIV/AIDS
counseling and testing, and appropriate referral to HIV/AIDS services;</text>
</clause><clause commented="no" id="HC3DBEB00790F43E1AB05DFDCE87BA189"><enum>(iii)</enum><text display-inline="yes-display-inline">the number and location of laboratories
with the capacity to perform tuberculosis culture tests and tuberculosis drug
susceptibility tests;</text>
</clause><clause commented="no" id="HA84ED9F0C99B4666A52DF56B21180027"><enum>(iv)</enum><text display-inline="yes-display-inline">the number and location of laboratories
with the capacity to perform appropriate tests for multi-drug resistant
tuberculosis (MDR–TB) and extensively drug resistant tuberculosis (XDR–TB);
and</text>
</clause><clause commented="no" id="H4A0849A9F40E4D1E9D4456A7304E59D6"><enum>(v)</enum><text display-inline="yes-display-inline">the number of HIV-infected individuals
suspected of having tuberculosis who are provided tuberculosis culture
diagnosis or tuberculosis drug susceptibility testing;</text>
</clause></subparagraph><subparagraph commented="no" id="HF27B3F8CAC974F96A2B9077EFACCB08D"><enum>(E)</enum><text display-inline="yes-display-inline">a description of coordination efforts with
relevant executive branch agencies (as such term is defined in section 3 of the
United States Leadership Against HIV/AIDS, Tuberculosis, and Malaria Act of
2003) and at the global level in the effort to link HIV/AIDS services with
non-HIV/AIDS services;</text>
</subparagraph><subparagraph commented="no" id="H6E3351C7F458425BB0247647C5DE788D"><enum>(F)</enum><text display-inline="yes-display-inline">a description of programs serving women and
girls, including—</text>
<clause commented="no" id="H18279234DC134836AE0026519B756DAA"><enum>(i)</enum><text>a description of
HIV/AIDS prevention programs that address the vulnerabilities of girls and
women to HIV/AIDS; and</text>
</clause><clause commented="no" id="HEAC717E7789B450E9E686445EB19B691"><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;</text>
</clause></subparagraph><subparagraph commented="no" id="H624F57BBE78E4B85A58B6EEC438A259"><enum>(G)</enum><text display-inline="yes-display-inline">a description of the specific strategies
funded to ensure the reduction of HIV infection among injection drug users, and
the number of injection drug users, by country, reached by such strategies,
including medication-assisted drug treatment for individuals with HIV or at
risk of HIV, and HIV prevention programs demonstrated to be effective in
reducing HIV transmission without increasing drug use; and</text>
</subparagraph><subparagraph id="HA160F1AC22D64B489F7D1F316B6249EC"><enum>(H)</enum><text>a detailed
description of monitoring, impact evaluation research, and operations research
of programs, projects, and activities carried out pursuant to subsection
(d)(4)(A)(v).</text>
</subparagraph><after-quoted-block>;
and</after-quoted-block></quoted-block>
</clause></subparagraph><subparagraph id="HDB9331C6156F4788A412B5ED9C28ED93"><enum>(C)</enum><text>by adding at the
end the following:</text>
<quoted-block display-inline="no-display-inline" id="H98B944842BEE40E2B9F954E9DC611869" style="OLC">
<paragraph id="HD6EDC14DF6FF48AF00CC87173E5DD668"><enum>(3)</enum><header>Public
availability</header><text display-inline="yes-display-inline">The Coordinator
of United States Government Activities to Combat HIV/AIDS Globally shall make
publicly available on the Internet website of the Office of the Coordinator the
information contained in paragraph (2)(H) of each report and, in addition, the
individual evaluations and other reports that were the basis of such
information, including lessons learned and collected in such evaluations and
reports.</text>
</paragraph><after-quoted-block>.</after-quoted-block></quoted-block>
</subparagraph></paragraph></subsection><subsection id="H090B2409989D48C28E328BF9D9C17769"><enum>(b)</enum><header>Authorization of
appropriations</header><text display-inline="yes-display-inline">Subsection (b)
of section 301 of the United States Leadership Against HIV/AIDS, Tuberculosis,
and Malaria Act of 2003 (<external-xref legal-doc="usc" parsable-cite="usc/22/7631">22 U.S.C. 7631</external-xref>) is amended—</text>
<paragraph id="H7D297E22453B42D5BE00647353EF5200"><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="HD526C525E2F34F2CBBEFD008755042AC"><enum>(2)</enum><text display-inline="yes-display-inline">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="H51989B3A8DDE413982ACFA07A7C86154"><enum>(c)</enum><header>Food security
and nutrition support</header><text display-inline="yes-display-inline">Subsection (c) of such section is amended
to read as follows:</text>
<quoted-block display-inline="no-display-inline" id="H17232004354545AF84CBAAD350751981" style="OLC">
<subsection id="H8DBF077A34B042F7ADDC35AE84521C27"><enum>(c)</enum><header>Food security
and nutrition support</header>
<paragraph id="H957C1D5C9FD54D5BAE8600F484B8BE34"><enum>(1)</enum><header>Findings</header><text display-inline="yes-display-inline">Congress finds the following:</text>
<subparagraph id="H2CD251271E164F5DB2B5D9AC8CDEB83F"><enum>(A)</enum><text>The United States
provides more than 60 percent of all food assistance worldwide.</text>
</subparagraph><subparagraph id="HA6D80FCB1CDF404E0015DBB9B4A5DCB1"><enum>(B)</enum><text>According to the
United Nations World Food Program and other United Nations agencies, food
insecurity of individuals with HIV/AIDS is a major problem in countries with
large populations of such individuals, particularly in sub-Saharan African
countries.</text>
</subparagraph><subparagraph id="HAE123A14F90345B0A007F1DF37EE7EDD"><enum>(C)</enum><text display-inline="yes-display-inline">Individuals infected with HIV have higher
nutritional requirements than individuals who are not infected with HIV,
particularly with respect to the need for protein. Also, there is evidence to
suggest that the full benefit of therapy to treat HIV/AIDS may not be achieved
in individuals who are malnourished, particularly in pregnant and lactating
women.</text>
</subparagraph></paragraph><paragraph id="HF5DC8796899242E783D0057EE923AF88"><enum>(2)</enum><header>Sense of
congress</header><text>It is the sense of Congress that—</text>
<subparagraph id="HFEFCA688C4FA440DBF00D7E1C9C3356"><enum>(A)</enum><text>malnutrition,
especially for individuals with HIV/AIDS, is a clinical health issue with wider
nutrition, health, and social implications for such individuals, their
families, and their communities that must be addressed by United States
HIV/AIDS prevention, treatment, and care programs;</text>
</subparagraph><subparagraph id="H042901DF9E4844F993374B4B3100C409"><enum>(B)</enum><text>food security and
nutrition directly impact an individual’s vulnerability to HIV infection, the
progression of HIV to AIDS, an individual’s ability to begin an antiretroviral
medication treatment regimen, the efficacy of an antiretroviral medication
treatment regimen once an individual begins such a regimen, and the ability of
communities to effectively cope with the HIV/AIDS epidemic and its
impacts;</text>
</subparagraph><subparagraph id="H12548D04DC1D43479314CBDD5C06AE1C"><enum>(C)</enum><text>international
guidelines established by the World Health Organization (WHO) should serve as
the reference standard for HIV/AIDS food and nutrition activities supported by
this Act and the amendments made by this Act;</text>
</subparagraph><subparagraph id="H5774305E579F43E28B1584FC32194723"><enum>(D)</enum><text>the Coordinator of
United States Government Activities to Combat HIV/AIDS Globally and the
Administrator of the United States Agency for International Development should
make it a priority to work together and with other United States Government
agencies, donors, and multilateral institutions to increase the integration of
food and nutrition support and livelihood activities into HIV/AIDS prevention,
treatment, and care activities funded by the United States and other
governments and organizations;</text>
</subparagraph><subparagraph id="HE7368A706BD24644A66D6E44CFC93FB6"><enum>(E)</enum><text>for purposes of
determining which individuals infected with HIV should be provided with
nutrition and food support—</text>
<clause id="H7A5EF02F98C94B2FAACF8B343003F7F"><enum>(i)</enum><text display-inline="yes-display-inline">children with moderate or severe
malnutrition, according to WHO standards, shall be given priority for such
nutrition and food support; and</text>
</clause><clause id="H61958967BAFE43E8888300554C123F45"><enum>(ii)</enum><text>adults with a
body mass index (BMI) of 18.5 or less, or at the prevailing WHO-approved
measurement for BMI, should be considered <quote>malnourished</quote> and
should be given priority for such nutrition and food support;</text>
</clause></subparagraph><subparagraph id="HD2A0DE8DDD504A9BAECC7D4F4681F5C9"><enum>(F)</enum><text>programs funded by
the United States should include therapeutic and supplementary feeding, food,
and nutrition support and should include strong links to development programs
that provide support for livelihoods; and</text>
</subparagraph><subparagraph id="HFAA3E026D8394CF5A1B8330622E953DE"><enum>(G)</enum><text>the inability of
individuals with HIV/AIDS to access food for themselves or their families
should not be allowed to impair or erode the therapeutic status of such
individuals with respect to HIV/AIDS or related co-morbidities.</text>
</subparagraph></paragraph><paragraph id="H7A5706A4A19646998090E39BD41CFD26"><enum>(3)</enum><header>Statement of
policy</header><text>It is the policy of the United States to—</text>
<subparagraph id="HC6D7886A12D14603B0C21418F399F2D8"><enum>(A)</enum><text>address the food
and nutrition needs of individuals with HIV/AIDS and affected individuals,
including orphans and vulnerable children;</text>
</subparagraph><subparagraph id="HD86FB74D52334AA9BBFE11F39EDBDE37"><enum>(B)</enum><text>fully integrate
food and nutrition support into HIV/AIDS prevention, treatment, and care
programs carried out under this Act and the amendments made by this Act;</text>
</subparagraph><subparagraph id="H86E673FD4EB348B492B8CA44BCF8D9F4"><enum>(C)</enum><text>ensure, to the
extent practicable, that—</text>
<clause id="H199A360893E542C88BAD14B51C30751E"><enum>(i)</enum><text>HIV/AIDS
prevention, treatment, and care providers and health care workers are
adequately trained so that such providers and workers can provide accurate and
informed information regarding food and nutrition support to individuals
enrolled in treatment and care programs and individuals affected by HIV/AIDS;
and</text>
</clause><clause id="H54AE850C496E4EB2B5367F4C17001771"><enum>(ii)</enum><text>individuals with
HIV/AIDS who, with their households, are identified as food insecure are
provided with adequate food and nutrition support; and</text>
</clause></subparagraph><subparagraph id="H676BB070ED094FF38187DF23881DDD35"><enum>(D)</enum><text>effectively link
food and nutrition support provided under this Act and the amendments made by
this Act to individuals with HIV/AIDS, their households, and their communities,
to other food security and livelihood programs funded by the United States and
other donors and multilateral agencies.</text>
</subparagraph></paragraph><paragraph id="H4CE0F8A4267B48CB99520801675D9C08"><enum>(4)</enum><header>Integration of
food security and nutrition activities into hiv/aids prevention, treatment, and
care activities</header>
<subparagraph id="H28CA49042D194B76B6DC68813D31C065"><enum>(A)</enum><header>Requirements
relating to Global AIDS coordinator</header><text>Consistent with the statement
of policy described in paragraph (3), the Coordinator of United States
Government Activities to Combat HIV/AIDS Globally shall—</text>
<clause id="HD408CF7CFA2C4EB49206973F240071C8"><enum>(i)</enum><text>ensure, to the
extent practicable, that—</text>
<subclause id="H10DE42FFDE2B40A7B35D240092E6D566"><enum>(I)</enum><text>an assessment,
using validated criteria, of the food security and nutritional status of each
individual enrolled in antiretroviral medication treatment programs supported
with funds authorized under this Act or any amendment made by this Act is
carried out; and</text>
</subclause><subclause id="H2C0B06FCF6BE4E0E95126D2F4D464492"><enum>(II)</enum><text>appropriate
nutritional counseling is provided to each individual described in subclause
(I);</text>
</subclause></clause><clause id="HEE034C1E891847C18DEAF2E5EF7D8EF"><enum>(ii)</enum><text>coordinate with
the Administrator of the United States Agency for International Development,
the Secretary of Agriculture, and the heads of other relevant executive branch
agencies to—</text>
<subclause id="HBA922ED4DB5F42AC8EE33E12162B096B"><enum>(I)</enum><text>ensure, to the
extent practicable, that, in communities in which a significant proportion of
individuals with HIV/AIDS are in need of food and nutrition support, a status
and needs assessment for such support employing validated criteria is conducted
and a plan to provide such support is developed and implemented;</text>
</subclause><subclause id="H48DFB1A9FDDF4674A99C8B91D2547DE6"><enum>(II)</enum><text>improve and
enhance coordination between food security and livelihood programs for
individuals infected with HIV in host countries and food security and
livelihood programs that may already exist in such countries;</text>
</subclause><subclause id="HB165D6165C744BDE83A2E60050334EE4"><enum>(III)</enum><text>establish
effective linkages between the health and agricultural development and
livelihoods sectors in order to enhance food security; and</text>
</subclause><subclause id="HA6F8916988C947A6ADF4C92E6D12F5C4"><enum>(IV)</enum><text>ensure, by
providing increased resources if necessary, effective coordination between
activities authorized under this Act and the amendments made by this Act and
activities carried out under other provisions of the Foreign Assistance Act of
1961 when establishing new HIV/AIDS treatment sites;</text>
</subclause></clause><clause id="H0B769C1A0B9946208994A4E8AD83A5ED"><enum>(iii)</enum><text>develop
effective, validated indicators that measure outcomes of nutrition and food
security interventions carried out under this section and use such indicators
to monitor and evaluate the effectiveness of such interventions; and</text>
</clause><clause id="HD9489E309DC7472091A195ED1C2B76A6"><enum>(iv)</enum><text>evaluate the role
of and, to the extent appropriate, support and expand partnerships and linkages
between United States postsecondary educational institutions with postsecondary
educational institutions in host countries in order to provide training and
build indigenous human and institutional capacity and expertise to respond to
HIV/AIDS, and to improve capacity to address nutrition, food security, and
livelihood needs of HIV/AIDS-affected and impoverished communities.</text>
</clause></subparagraph><subparagraph id="H8168631DF3B5463A8438EA3910E72D10"><enum>(B)</enum><header>Requirements
relating to USAID administrator</header><text display-inline="yes-display-inline">Consistent with the statement of policy
described in paragraph (3), 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 and the Secretary of
Agriculture, shall provide, to the extent practicable, as an essential
component of antiretroviral medication treatment programs supported with funds
authorized under this Act and the amendments made by this Act, food and
nutrition support to each individual with HIV/AIDS who is determined to need
such support by the assessing health professional, based on a body mass index
(BMI) of 18.5 or less, or at the prevailing WHO-approved measurement for BMI,
and the individual’s household, for a period of not less than 180 days, either
directly or through referral to an assistance program or organization with
demonstrable ability to provide such support.</text>
</subparagraph><subparagraph id="H452AB59A6BE5486C9133F2CE1B1EB34"><enum>(C)</enum><header>Report</header><text display-inline="yes-display-inline">Not later than October 31, 2010, and
annually thereafter, the Coordinator of United States Government Activities to
Combat HIV/AIDS Globally, in consultation with the Administrator of the United
States Agency for International Development, shall submit to the appropriate
congressional committees a report on the implementation of this subsection for
the prior fiscal year. The report shall include a description of—</text>
<clause id="HE91A09780AC24651BC22253EEEAFC208"><enum>(i)</enum><text>the effectiveness
of interventions carried out to improve the nutritional status of individuals
with HIV/AIDS;</text>
</clause><clause id="H227A15B646DA4460BA4DF73D1F6F673"><enum>(ii)</enum><text>the amount of
funds provided for food and nutrition support for individuals with HIV/AIDS and
affected individuals in the prior fiscal year and the projected amount of funds
to be provided for such purpose for next fiscal year; and</text>
</clause><clause id="H3DB91CB7AB0845F4817CBE8E7D3B132F"><enum>(iii)</enum><text>a strategy for
improving the linkage between assistance provided with funds authorized under
this subsection and food security and livelihood programs under other
provisions of law as well as activities funded by other donors and multilateral
organizations.</text>
</clause></subparagraph><subparagraph commented="no" id="HAF1C83D920D140D6884FA296F3511BFD"><enum>(D)</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 President such sums as may be necessary for each of the fiscal years 2009
through 2013 to carry out this
subsection.</text>
</subparagraph></paragraph></subsection><after-quoted-block>.</after-quoted-block></quoted-block>
</subsection><subsection id="HD3FC848305D4426BAE23A1B6C5700F2"><enum>(d)</enum><header>Eligibility for
assistance</header><text>Subsection (d) of such section is amended to read as
follows:</text>
<quoted-block display-inline="no-display-inline" id="H8D6E328CCF174D9C95E471B82F968841" style="OLC">
<subsection id="H720AC05A6CF44AFD8627E0D03E00E1B3"><enum>(d)</enum><header>Eligibility for
assistance</header><text display-inline="yes-display-inline">An organization,
including a faith-based organization, that is otherwise eligible to receive
assistance under section 104A of the Foreign Assistance Act of 1961 (as added
by subsection (a)) or under any other provision of this Act (or any amendment
made by this Act or the Tom Lantos and Henry J. Hyde Global Leadership Against
HIV/AIDS, Tuberculosis, and Malaria Reauthorization Act of 2008) to prevent,
treat, or monitor HIV/AIDS—</text>
<paragraph id="H6C4E34A92FD14985B54F1FEA251F8F26"><enum>(1)</enum><text>shall not be
required, as a condition of receiving the assistance, to endorse or utilize a
multisectoral approach to combating HIV/AIDS, or 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>
</paragraph><paragraph id="H34C5E6FDCB3943AD859EC0A0A083F00"><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 do
so.</text>
</paragraph></subsection><after-quoted-block>.</after-quoted-block></quoted-block>
</subsection><subsection id="HB9C74DCE064E4395B38C820005D600E3"><enum>(e)</enum><header>Sense of
Congress</header><text display-inline="yes-display-inline">Such section is
further amended by striking subsection (g).</text>
</subsection><subsection id="H0BB72090C93A4232BD68B8007FA14877"><enum>(f)</enum><header>Report</header>
<paragraph id="H164D3FBF32A64B0891B6358EC9B2BDC8"><enum>(1)</enum><header>In
general</header><text>Not later than 270 days after the date of the enactment
of this Act, the Coordinator of United States Government Activities to Combat
HIV/AIDS Globally shall submit to the appropriate congressional committees a
report identifying a target for the number of additional health professionals
and workers needed in host countries to provide HIV/AIDS prevention, treatment,
and care and the training needs of such health professionals and workers. The
target should reflect available data and should identify the need for United
States Government contributions to meet the target.</text>
</paragraph><paragraph id="HBAC4797C91A14B95AE18D3D9F34BF675"><enum>(2)</enum><header>Definition</header><text>In
this subsection, the term <term>appropriate congressional committees</term> has
the meaning given the term in section 3 of the United States Leadership Against
HIV/AIDS, Tuberculosis, and Malaria Act of 2003 (<external-xref legal-doc="usc" parsable-cite="usc/22/7602">22 U.S.C. 7602</external-xref>).</text>
</paragraph></subsection></section><section commented="no" id="H2197D0CA777B4E79A9E880BBFA7F9562"><enum>302.</enum><header>Assistance to
combat tuberculosis</header>
<subsection commented="no" id="HA14317E830204B4082D95E101C4D6B26"><enum>(a)</enum><header>Amendments to
the Foreign Assistance Act of 1961</header>
<paragraph commented="no" id="H1BB0ECE6D72045A491E54B0451D624F0"><enum>(1)</enum><header>Findings</header><text>Subsection
(a) of section 104B of the Foreign Assistance Act of 1961 (<external-xref legal-doc="usc" parsable-cite="usc/22/2151b-3">22 U.S.C. 2151b–3</external-xref>)
is amended by striking paragraphs (1) and (2) and inserting the
following:</text>
<quoted-block display-inline="no-display-inline" id="HBE34B47574184AB6BD4E87C115C38367" style="OLC">
<paragraph commented="no" id="HB066272BCADD4DAEA05C192B9B733843"><enum>(1)</enum><text display-inline="yes-display-inline">Tuberculosis is one of the greatest
infectious causes of death of adults worldwide, killing 1.6 million individuals
per year—one person every 20 seconds.</text>
</paragraph><paragraph commented="no" id="HD45C8CAFC5C242F1B80056B31C6348CC"><enum>(2)</enum><text>Tuberculosis is
the leading infectious cause of death among individuals who are infected with
HIV due to their weakened immune systems, and it is estimated that one-third of
such individuals have tuberculosis. Tuberculosis is also a leading killer of
women of reproductive age.</text>
</paragraph><paragraph commented="no" id="H41B62AA49D6244CB80BEDE3D7F68785"><enum>(3)</enum><text>Driven by the
HIV/AIDS pandemic, incidence rates of tuberculosis in sub-Saharan Africa have
more than doubled on average since 1990. The problem is so pervasive that in
August 2005, African health ministers and the World Health Organization (WHO)
declared tuberculosis to be an emergency in sub-Saharan Africa.</text>
</paragraph><paragraph commented="no" id="H3E25265BE4FF456EA399C3EAEDFA3010"><enum>(4)</enum><subparagraph commented="no" display-inline="yes-display-inline" id="H0C48DB3D019349738367C40633A060E6"><enum>(A)</enum><text>The wide extent of drug
resistance, including both multi-drug resistant tuberculosis (MDR–TB) and
extensively drug resistant tuberculosis (XDR–TB), represents both a critical
challenge to the global control of tuberculosis and a serious worldwide public
health threat.</text>
</subparagraph><subparagraph commented="no" id="HAD04AD18DD54469AB901A1C3AB8B07F9" indent="up1"><enum>(B)</enum><text>XDR–TB, which is a form of MDR–TB with
additional resistance to multiple second-line anti-tuberculosis drugs, is
associated with worst treatment outcomes of any form of tuberculosis.</text>
</subparagraph><subparagraph commented="no" id="HE7E711BE5F4649948DD28C86C58F557F" indent="up1"><enum>(C)</enum><text>XDR–TB is converging with the HIV/AIDS
epidemic, undermining gains in HIV/AIDS prevention and treatment programs and
requires urgent interventions.</text>
</subparagraph><subparagraph commented="no" id="H0FEACD77F47E4F65A77D02A2EEAB789E" indent="up1"><enum>(D)</enum><text>Drug resistance surveillance reports
have confirmed the serious scale and spread of tuberculosis, with XDR–TB
strains confirmed on six continents.</text>
</subparagraph><subparagraph commented="no" id="HB778B9B97A1A4EC684A6DEC5FEFA4B7" indent="up1"><enum>(E)</enum><text>Demonstrating the lethality of XDR–TB,
an initial outbreak in Tugela Ferry, South Africa, in 2006 killed 52 of 53
patients with hundreds more cases reported since that time.</text>
</subparagraph><subparagraph commented="no" id="HF3396B6E1AE34EE9BB01E3E41FC3B6FA" indent="up1"><enum>(F)</enum><text>Of the world’s regions, sub-Saharan
Africa, faces the greatest gap in capacity to prevent, treat, and care for
individuals with
XDR–TB.</text>
</subparagraph></paragraph><after-quoted-block>.</after-quoted-block></quoted-block>
</paragraph><paragraph id="H37666EFFDCE84D12899B8CD33B76FF79"><enum>(2)</enum><header>Policy</header><text display-inline="yes-display-inline">Subsection (b) of such section is amended
to read as follows:</text>
<quoted-block display-inline="no-display-inline" id="H8D960C9D49D24E21B9B663EF8EFB3" style="OLC">
<subsection id="H1C97B6118A3F4AA889D3A3664FCFEC23"><enum>(b)</enum><header>Policy</header><text display-inline="yes-display-inline">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 Government should prioritize the achievement of the following goals by
not later than December 31, 2015:</text>
<paragraph id="HFF58573B589A410FB038C766D8AF3153"><enum>(1)</enum><text display-inline="yes-display-inline">Reduce by one-half the tuberculosis death
and disease burden from the 1990 baseline.</text>
</paragraph><paragraph id="H8C13274FFC22429497A1952724934083"><enum>(2)</enum><text display-inline="yes-display-inline">Sustain or exceed the detection of at least
70 percent of sputum smear-positive cases of tuberculosis and the cure of at
least 85 percent of such cases
detected.</text>
</paragraph></subsection><after-quoted-block>.</after-quoted-block></quoted-block>
</paragraph><paragraph commented="no" display-inline="no-display-inline" id="HDB851996A1F3459291CF144E74CAED8C"><enum>(3)</enum><header>Activities
supported</header><text display-inline="yes-display-inline">Such section is
further amended—</text>
<subparagraph commented="no" id="H7A159F08E5F64B49A46209FB6C501F5D"><enum>(A)</enum><text>by redesignating
subsections (d) through (f) as subsections (e) through (g); and</text>
</subparagraph><subparagraph commented="no" id="HC48B588EC28D4FE6008D7681ED7078FD"><enum>(B)</enum><text>by inserting after
subsection (c) the following:</text>
<quoted-block display-inline="no-display-inline" id="H0674949379554458A8D5A8152081F9F7" style="OLC">
<subsection commented="no" id="H7D44C176715A4A028CA57E4808E40153"><enum>(d)</enum><header>Activities
supported</header><text>Assistance provided under subsection (c) shall, to the
maximum extent practicable, be used to carry out the following
activities:</text>
<paragraph commented="no" id="H40C8AC5FD84E4B74987107C66FED3F72"><enum>(1)</enum><text display-inline="yes-display-inline">Provide diagnostic counseling and testing
to individuals with HIV/AIDS for tuberculosis (including a culture diagnosis to
rule out multi-drug resistant tuberculosis (MDR–TB) and extensively drug
resistant tuberculosis (XDR–TB) and provide HIV/AIDS voluntary counseling and
testing to individuals with any form of tuberculosis.</text>
</paragraph><paragraph commented="no" id="H353FFCB6DC0D4F6E862E77BAA8A458E2"><enum>(2)</enum><text display-inline="yes-display-inline">Provide tuberculosis treatment to
individuals receiving treatment and care for HIV/AIDS who have active
tuberculosis and provide prophylactic treatment to individuals with HIV/AIDS
who also have a latent tuberculosis infection.</text>
</paragraph><paragraph commented="no" id="H962232C5701A4B3884D9C74525C50D3"><enum>(3)</enum><text display-inline="yes-display-inline">Link individuals with both HIV/AIDS and
tuberculosis to HIV/AIDS treatment and care services, including antiretroviral
therapy and cotrimoxazole therapy.</text>
</paragraph><paragraph commented="no" id="H92244846FD27435096EC854D36541663"><enum>(4)</enum><text display-inline="yes-display-inline">Ensure that health care workers trained to
diagnose, treat, and provide care for HIV/AIDS are also trained to diagnose,
treat, and provide care for individuals with both HIV/AIDS and
tuberculosis.</text>
</paragraph><paragraph commented="no" id="HD0334C79DF7B4F3A85DC0016C4C4BBF7"><enum>(5)</enum><text display-inline="yes-display-inline">Ensure that individuals with active
pulmonary tuberculosis are provided a culture diagnosis, including drug
susceptibility testing to rule out multi-drug resistant tuberculosis (MDR–TB)
and extensively drug resistant tuberculosis (XDR–TB) in areas with high
prevalence of tuberculosis drug
resistance.</text>
</paragraph></subsection><after-quoted-block>.</after-quoted-block></quoted-block>
</subparagraph></paragraph><paragraph id="HFF8A572283F04D3CADA85E92A5A7546"><enum>(4)</enum><header>Priority To Stop
TB Strategy</header><text>Subsection (f) of such section (as redesignated by
paragraph (3) of this subsection) is amended—</text>
<subparagraph id="HF436AE99D0244F45BF6D1D5EB7095C74"><enum>(A)</enum><text>by amending the
heading to read as follows: <quote><header-in-text level="subsection" style="OLC">Priority To Stop TB Strategy</header-in-text></quote>;</text>
</subparagraph><subparagraph id="H5FC6A5B74EDC45B9811C94A0BCFBDE42"><enum>(B)</enum><text>in the first
sentence, by striking <quote>In furnishing</quote> and all that follows through
<quote>, including funding</quote> and inserting the following:</text>
<quoted-block display-inline="no-display-inline" id="H9D13D408387B43F79E69CFB53BB96953" style="OLC">
<paragraph id="H2EA52665C8004B468FAA9CC66C9F35DD"><enum>(1)</enum><header>Priority</header><text>In
furnishing assistance under subsection (c), the President shall give priority
to—</text>
<subparagraph id="H721EF522AD2C4C0BBBBE6691775F66D3"><enum>(A)</enum><text>activities
described in the Stop TB Strategy, including expansion and enhancement of
Directly Observed Treatment Short-course (DOTS) coverage, 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
care 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>
</subparagraph><subparagraph id="H1CB7C2BB329547C3ABFFC1E673BF9E7B"><enum>(B)</enum><text>funding</text>
</subparagraph></paragraph><after-quoted-block>;
and</after-quoted-block></quoted-block>
</subparagraph><subparagraph id="HAC8A981256AC49C400DFBD55DE96B55C"><enum>(C)</enum><text>in the second
sentence—</text>
<clause id="H0803C1C7568A4EC1852CE309BB080686"><enum>(i)</enum><text>by
striking <quote>In order to</quote> and all that follows through <quote>not
less than</quote> and inserting the following:</text>
<quoted-block id="H0FB33368BB8F48B39335D9A3A41BB1B0" style="OLC">
<paragraph id="H527B473289764621B40383E4700DFF6"><enum>(2)</enum><header>Availability of
amounts</header><text>In order to meet the requirements of paragraph (1), the
President—</text>
<subparagraph id="H67FCBBCD0E7E4511BF4F3DF6E97F95BC"><enum>(A)</enum><text>shall ensure that
not less
than</text>
</subparagraph></paragraph><after-quoted-block>;</after-quoted-block></quoted-block>
</clause><clause id="H783E9751DDB6440386FFE9ADBBC34FB3"><enum>(ii)</enum><text>by
striking <quote>for Directly Observed Treatment Short-course (DOTS) coverage
and treatment of multi-drug resistant tuberculosis using DOTS–Plus,</quote> and
inserting <quote>to implement the Stop TB Strategy; and</quote>; and</text>
</clause><clause id="H68664E01DC9E418DA6B573E98BA6AB75"><enum>(iii)</enum><text>by
striking <quote>including</quote> and all that follows and inserting the
following:</text>
<quoted-block id="H1F7DF8CB231547A782D830C6472DAD25" style="OLC">
<subparagraph id="HCC4C369136AA455592003D861FC55C00"><enum>(B)</enum><text>should ensure that
not less than $15,000,000 of the amount made available to carry out this
section for a fiscal year is used to make a contribution to the Global
Tuberculosis Drug
Facility.</text>
</subparagraph><after-quoted-block>.</after-quoted-block></quoted-block>
</clause></subparagraph></paragraph><paragraph id="H7BC4FED6F29B495DACC4FDF075815CF4"><enum>(5)</enum><header>Assistance for
WHO and the Stop Tuberculosis Partnership</header><text>Such section is further
amended—</text>
<subparagraph id="HE470B6E7A1F044F6A3F82782C85F008C"><enum>(A)</enum><text>by redesignating
subsection (g) (as redesignated by paragraph (3) of this subsection) as
subsection (h); and</text>
</subparagraph><subparagraph id="H9838AA80581C464B8EDAEF880C68FE6"><enum>(B)</enum><text display-inline="yes-display-inline">by inserting after subsection (f) (as
redesignated by paragraph (4) and amended by paragraph (5) of this subsection)
the following new subsection:</text>
<quoted-block id="H2F5F113FB63D43A38EF726E9C907846E" style="OLC">
<subsection id="H13F7040507D1440DA074AA4018738D6C"><enum>(g)</enum><header>Assistance for
WHO 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 (WHO) 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 extensively drug resistant
tuberculosis
(XDR–TB).</text>
</subsection><after-quoted-block>.</after-quoted-block></quoted-block>
</subparagraph></paragraph><paragraph id="H1D2526AC97B44568BC5600348C133D01"><enum>(6)</enum><header>Definitions</header><text>Subsection
(h) of such section (as redesignated by paragraph (5)(A) of this subsection) is
amended—</text>
<subparagraph id="HF3C31E6A7444439080DB00043CF4D08E"><enum>(A)</enum><text>in paragraph (1),
by adding at the end before the period the following: <quote>, including low
cost and effective diagnosis and evaluation of treatment regimes, vaccines, and
monitoring of tuberculosis, as well as a reliable drug supply, and a management
strategy for public health systems, with health system strengthening, promotion
of the use of the International Standards for Tuberculosis Care by all care
providers, bacteriology under an external quality assessment framework,
short-course chemotherapy, and sound reporting and recording systems</quote>;
and</text>
</subparagraph><subparagraph id="H0AAE66AD4BD84ABC87DA5C87D8C4FC87"><enum>(B)</enum><text>by adding after
paragraph (5) the following new paragraph:</text>
<quoted-block id="H45D64455EDF64F85AFEC0001CAF11FAD" style="OLC">
<paragraph id="HE5DE5AA916804635A4E53743B2F247E7"><enum>(6)</enum><header>Stop tb
strategy</header><text>The term <term>Stop TB Strategy</term> means the
six-point strategy to reduce tuberculosis developed by the World Health
Organization. The strategy is described in the Global Plan to Stop TB
2007–2016: Actions for Life, a comprehensive plan developed by the Stop
Tuberculosis Partnership that sets out the actions necessary to achieve the
millennium development goal of cutting tuberculosis deaths and disease burden
in half by
2016.</text>
</paragraph><after-quoted-block>.</after-quoted-block></quoted-block>
</subparagraph></paragraph></subsection><subsection commented="no" id="HFA644969A15A45FBB8A2B107009C0004"><enum>(b)</enum><header>Authorization of
appropriations</header><text display-inline="yes-display-inline">Section 302(b)
of the United States Leadership Against HIV/AIDS, Tuberculosis, and Malaria Act
of 2003 (<external-xref legal-doc="usc" parsable-cite="usc/22/7632">22 U.S.C. 7632(b)</external-xref>) is amended—</text>
<paragraph commented="no" id="H1D59199BC8424A549CBF3C172EF5752E"><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>$4,000,000,000 for fiscal years
2009 through 2013</quote>; and</text>
</paragraph><paragraph commented="no" id="HAE06F0FAE8DD4C5EAA2CE17378C007F0"><enum>(2)</enum><text display-inline="yes-display-inline">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 commented="no" id="H1EAA729043504956981610A7F59D4A5"><enum>303.</enum><header>Assistance to
combat malaria</header>
<subsection commented="no" id="H1B72356B18034CA9002FDF2BB8B31D5F"><enum>(a)</enum><header>Amendment to the
Foreign Assistance Act of 1961</header><text display-inline="yes-display-inline">Section 104C(b) of the Foreign Assistance
Act of 1961 (<external-xref legal-doc="usc" parsable-cite="usc/22/21516-4">22 U.S.C. 21516–4(b)</external-xref>) is amended by striking <quote>control, and
cure</quote> and inserting <quote>treatment, and care</quote>.</text>
</subsection><subsection commented="no" display-inline="no-display-inline" id="HC2986574FE964D58A2F3D0E1491DFB20"><enum>(b)</enum><header>Authorization of
appropriations</header><text display-inline="yes-display-inline">Section 303(b)
of the United States Leadership Against HIV/AIDS, Tuberculosis, and Malaria Act
of 2003 (<external-xref legal-doc="usc" parsable-cite="usc/22/7633">22 U.S.C. 7633(b)</external-xref>) is amended—</text>
<paragraph commented="no" id="H587BB5A833B24DF2AC91C62500A25113"><enum>(1)</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 for fiscal years 2009 through
2013</quote>; and</text>
</paragraph><paragraph commented="no" id="H712075EC65294B75A6CE3E19AFCD973B"><enum>(2)</enum><text display-inline="yes-display-inline">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 commented="no" id="H1A4DB500D2C641F7B9D495E9AB7393BB"><enum>(c)</enum><header>Development of a
comprehensive five-year strategy</header><text display-inline="yes-display-inline">Section 303 of the United States Leadership
Against HIV/AIDS, Tuberculosis, and Malaria Act of 2003 (<external-xref legal-doc="usc" parsable-cite="usc/22/7633">22 U.S.C. 7633</external-xref>) is
amended by adding at the end the following:</text>
<quoted-block display-inline="no-display-inline" id="H6EE88E42A4B249A08264000818F6F31C" style="OLC">
<subsection commented="no" id="H04F03FE3163649E0B3B261CF005F1F89"><enum>(d)</enum><header>Development of a
comprehensive five-year strategy</header><text>The President shall establish a
comprehensive, five-year strategy to combat global malaria that strengthens the
capacity of the United States to be an effective leader of international
efforts to reduce the global malaria disease burden. Such strategy shall
maintain sufficient flexibility and remain responsive to the ever-changing
nature of the global malaria challenge and shall—</text>
<paragraph commented="no" id="HDF92F57DBF8243929D0942F8DEA52134"><enum>(1)</enum><text>include specific
objectives, multisectoral approaches and strategies to treat and provide care
to individuals infected with malaria, to prevent the further spread of
malaria;</text>
</paragraph><paragraph commented="no" id="H7B60961BBF1B4CBFA1D2E34E38005FDA"><enum>(2)</enum><text>describe how this
strategy would contribute to the United States’ overall global health and
development goals;</text>
</paragraph><paragraph commented="no" id="H248E4DBA3CC84869B8AC00A807ADF6FE"><enum>(3)</enum><text>clearly explain
how proposed activities to combat malaria will be coordinated with other United
States global health activities, including the five-year global HIV/AIDS and
tuberculosis strategies developed pursuant to section 101 of this Act;</text>
</paragraph><paragraph commented="no" id="HBBAAF3689FBF493FB1AC4B2535F6FCB7"><enum>(4)</enum><text>expand
public-private partnerships and leveraging of resources to combat malaria,
including private sector resources;</text>
</paragraph><paragraph commented="no" id="H41B0EEBC6871478D80F8AF9221E09DDD"><enum>(5)</enum><text>coordinate among
relevant executive branch agencies providing assistance to combat malaria in
order to maximize human and financial resources and reduce unnecessary
duplication among such agencies and other donors;</text>
</paragraph><paragraph commented="no" id="H4991E0DD0E76442086B752BE364629C"><enum>(6)</enum><text>maximize United
States capabilities in the areas of technical assistance, training, and
research, including vaccine research, to combat malaria; and</text>
</paragraph><paragraph commented="no" id="HD75201B60D4449B193DE77C09DAA232D"><enum>(7)</enum><text>establish
priorities and selection criteria for the distribution of resources to combat
malaria based on factors such as the size and demographics of the population
with malaria, the needs of that population, the host countries’ existing
infrastructure, and the host countries’ ability to complement United States
efforts with strategies outlined in national malaria control plans.</text>
</paragraph></subsection><subsection commented="no" id="H9C87DB3286CE490A8058B2695323FAB1"><enum>(e)</enum><header>Malaria response
coordinator</header>
<paragraph commented="no" id="H80D539DE67FF4516A596E3BBF4782E29"><enum>(1)</enum><header>In
general</header><text display-inline="yes-display-inline">There should be
established within the United States Agency for International Development a
Coordinator of United States Government Activities to Combat Malaria Globally,
who should be appointed by the President.</text>
</paragraph><paragraph commented="no" id="H8EE9E51CFA804CE29C15A858D3A86836"><enum>(2)</enum><header>Authorities</header><text>The
Coordinator, acting through such nongovernmental organizations and relevant
executive branch agencies as may be necessary and appropriate to effect the
purposes of section 104C of the Foreign Assistance Act of 1961 (22 U.S.C.
2151b–4), is authorized—</text>
<subparagraph commented="no" id="H69362FC4DE2B4717969F14184E4E76D6"><enum>(A)</enum><text display-inline="yes-display-inline">to operate internationally to carry out
prevention, treatment, care, support, capacity development of health systems,
and other activities for combating malaria;</text>
</subparagraph><subparagraph commented="no" id="HD12801B894D24FFEBFF85366021919DD"><enum>(B)</enum><text>to transfer and
allocate funds to relevant executive branch agencies;</text>
</subparagraph><subparagraph commented="no" id="H579ECFBB49C5425CA9A6008676006338"><enum>(C)</enum><text>to provide grants
to, and enter into contracts with, nongovernmental organizations to carry out
the purposes of such section 104C;</text>
</subparagraph><subparagraph commented="no" id="H16B5E56E3E794D0FA405562DDE48CBFA"><enum>(D)</enum><text>to enter into
contracts and transfer and allocate funds to international organizations to
carry out the purposes of such section 104C; and</text>
</subparagraph><subparagraph commented="no" id="HA5761483A41648039B12E823658FF116"><enum>(E)</enum><text display-inline="yes-display-inline">to coordinate with a public-private
partnership to discover and develop effective new antimalarial drugs, including
drugs for multi-drug resistant malaria and malaria in pregnant women.</text>
</subparagraph></paragraph><paragraph commented="no" id="H28028683B44A44E993A12BA9FF08B84"><enum>(3)</enum><header>Duties</header>
<subparagraph commented="no" id="HEAEB30FBA3BE4573B99FAF74D60300BE"><enum>(A)</enum><header>In
general</header><text>The Coordinator shall have primary responsibility for the
oversight and coordination of all resources and global United States government
activities to combat malaria.</text>
</subparagraph><subparagraph commented="no" id="HD81653367A7047699CFE4C4D62A8F40"><enum>(B)</enum><header>Specific
duties</header><text>The Coordinator shall—</text>
<clause commented="no" id="H8315DE29B5384915A0B8EE2004948F52"><enum>(i)</enum><text>facilitate program
and policy coordination among relevant executive branch agencies and
nongovernmental organizations, including auditing, monitoring and evaluation of
such programs;</text>
</clause><clause commented="no" id="H54C4A6F402C14B9B00024B3BD8824066"><enum>(ii)</enum><text>ensure that each
relevant executive branch agency has sufficient resources to execute programs
in areas in which the agency has the greatest expertise, technical capability,
and potential for success;</text>
</clause><clause id="H13576E1403E447BD902DC700E0803F75"><enum>(iii)</enum><text display-inline="yes-display-inline">coordinate with the Office of the
Coordinator of United States Government Activities to Combat HIV/AIDS Globally
and equivalent managers of other relevant executive branch agencies that are
implementing global health programs to develop and implement program plans,
country-level interactions, and recipient administrative requirements in
countries in which more than one program operates;</text>
</clause><clause commented="no" id="HF32B3B9AE9CB4948BDB1BA99F948913"><enum>(iv)</enum><text>coordinate
relevant executive branch agency activities in the field, including
coordination of planning, implementation, and evaluation of malaria programs
with HIV/AIDS programs in countries in which both programs are being carried
out;</text>
</clause><clause commented="no" id="HC1F38228F35543589859A2BF3513B804"><enum>(v)</enum><text>pursue coordinate
program implementation with host governments, other donors, and the private
sector; and</text>
</clause><clause commented="no" id="H0212A3B75F9E461C87CD1DFA63314EB8"><enum>(vi)</enum><text>establish due
diligence criteria for all recipients of funds appropriated pursuant to the
authorizations of appropriations under section 401 for malaria
assistance.</text>
</clause></subparagraph></paragraph></subsection><subsection commented="no" id="H8E2282E91916409E91341BD7D486CACD"><enum>(f)</enum><header>Assistance to
who</header><text display-inline="yes-display-inline">In carrying out this
section, the President is authorized to make a United States contribution to
the Roll Back Malaria Partnership and the World Health Organization (WHO) to
improve the capacity of countries with high rates of malaria and other affected
countries to implement comprehensive malaria control programs.</text>
</subsection><subsection commented="no" id="HF4E5766183CC45A895FDCACD4F8DBAB4"><enum>(g)</enum><header>Annual
Report</header>
<paragraph commented="no" id="H8C441B1131D34939928D017838A9EDBE"><enum>(1)</enum><header>In
general</header><text display-inline="yes-display-inline">Not later than 270
days after the date of the enactment of the Tom Lantos and Henry J. Hyde Global
Leadership Against HIV/AIDS, Tuberculosis, and Malaria Reauthorization Act of
2008, and annually thereafter, the President shall transmit to the appropriate
congressional committees a report on United States assistance for the
prevention, treatment, control, and elimination of malaria.</text>
</paragraph><paragraph commented="no" id="H1B8062E5A8CF416A97682E2979FFA362"><enum>(2)</enum><header>Matters to be
included</header><text>The report required under paragraph (1) shall include a
description of—</text>
<subparagraph commented="no" id="H87EE2182EE2F4D15A9A84FCA34929BD7"><enum>(A)</enum><text>the countries and
activities to which malaria assistance has been allocated;</text>
</subparagraph><subparagraph commented="no" id="H376B965A3DE24FAF99B1DF57E9CB8C49"><enum>(B)</enum><text>the number of
people reached through malaria assistance programs;</text>
</subparagraph><subparagraph commented="no" id="H8CDB16DDE1A8442586001715ECA7CEB0"><enum>(C)</enum><text>the percentage and
number of children and mothers reached through malaria assistance
programs;</text>
</subparagraph><subparagraph commented="no" id="HD49A2D577A1E4D1E8F1440B7E65FB4A2"><enum>(D)</enum><text>research efforts
to develop new tools to combat malaria, including drugs and vaccines;</text>
</subparagraph><subparagraph commented="no" id="HA7B9F82881C84085895E6FA793D2DC33"><enum>(E)</enum><text>collaboration with
the World Health Organization (WHO), the Global Fund to Fight AIDS,
Tuberculosis and Malaria, other donor governments, and relevant executive
branch agencies to combat malaria;</text>
</subparagraph><subparagraph commented="no" id="H52DDFCE7D9674BA187F787865D265CE7"><enum>(F)</enum><text>quantified impact
of United States assistance on childhood morbidity and mortality;</text>
</subparagraph><subparagraph commented="no" id="H04558E4EBF534FDEBBA5CDCF0088AE99"><enum>(G)</enum><text>the number of
children who received immunizations through malaria assistance programs;
and</text>
</subparagraph><subparagraph commented="no" id="H04B28953603F4D359F276613DEA17018"><enum>(H)</enum><text>the number of
women receiving ante-natal care through malaria assistance
programs.</text>
</subparagraph></paragraph></subsection><after-quoted-block>.</after-quoted-block></quoted-block>
</subsection></section><section id="H37C8F8BBF0CA4C2C8C48941F3791BD82"><enum>304.</enum><header>Health care
partnerships to combat HIV/AIDS</header>
<subsection id="H62F67832FEEA444E8D87009FC51BEDA"><enum>(a)</enum><header>In
general</header><text display-inline="yes-display-inline">Title III of the
United States Leadership Against HIV/AIDS, Tuberculosis, and Malaria Act of
2003 (<external-xref legal-doc="usc" parsable-cite="usc/22/7631">22 U.S.C. 7631 et seq.</external-xref>) is amended by striking section 304 and inserting
the following:</text>
<quoted-block display-inline="no-display-inline" id="H2949902EEBBE41A9A7DF07A2F30085B7" style="OLC">
<section id="H511EF0C538B04059A7AD3C88183C6C09"><enum>304.</enum><header>Health care
partnerships to combat HIV/AIDS</header>
<subsection id="H06E76D980D29418F8D00A670035AD54"><enum>(a)</enum><header>Sense of
congress</header><text>It is the sense of Congress that the use of health care
partnerships that link United States and host country health care institutions
create opportunities for sharing of knowledge and expertise among individuals
with significant experience in health-related fields and build local capacity
to combat HIV/AIDS and increase scientific understanding of the progression of
HIV/AIDS and the HIV/AIDS epidemic.</text>
</subsection><subsection id="H540E0B98C573426A934037F21E24E757"><enum>(b)</enum><header>Authority To
facilitate health care partnerships To combat HIV/AIDS</header><text display-inline="yes-display-inline">The President, acting through the
Coordinator of United States Government Activities to Combat HIV/AIDS Globally,
shall facilitate the development of health care partnerships described in
subsection (a) by—</text>
<paragraph id="H9794543D3EEB47F89FBBE1F25E30A13D"><enum>(1)</enum><text display-inline="yes-display-inline">supporting short- and long-term
institutional partnerships, including partnerships that build human and
institutional capacity in ministries of health, central- and district-level
health agencies, medical facilities, health education and training
institutions, academic centers, and faith- and community-based organizations
involved in prevention, treatment, and care of HIV/AIDS;</text>
</paragraph><paragraph id="H315ED5238C574092A9724E01D9E281BD"><enum>(2)</enum><text display-inline="yes-display-inline">supporting the development of consultation
services using appropriate technologies, including online courses, DVDs,
telecommunications services, partnerships, and other technologies to eliminate
the barriers that prevent host country professionals from accessing high
quality health care services information, particularly providers located in
rural areas;</text>
</paragraph><paragraph id="HBA71BF9621F549F4B0E9C12730B1A1C5"><enum>(3)</enum><text>supporting the
placements of highly qualified individuals to strengthen human and
organizational capacity through the use of health care professionals to
facilitate skills transfer, building local capacity, and to expand rapidly the
pool of providers, managers, and other health care staff delivering HIV/AID
services in host countries; and</text>
</paragraph><paragraph id="HE1FE539910504714912D188462BED2C"><enum>(4)</enum><text>meeting individual
country needs and, where possible, insisting on the implementation of a
national strategic plan, by providing training and mentoring to strengthen
human and organizational capacity among local health care service
organizations.</text>
</paragraph></subsection><subsection id="HD29CC443AEA24BEA975216EEB7C2FB27"><enum>(c)</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 President such sums as may be necessary for each of the fiscal years 2009
through 2013 to carry out this
section.</text>
</subsection></section><after-quoted-block>.</after-quoted-block></quoted-block>
</subsection><subsection id="HDB3B06498F88492282D203C6D3A6E0CA"><enum>(b)</enum><header>Clerical
amendment</header><text>The table of contents for the United States Leadership
Against HIV/AIDS, Tuberculosis, and Malaria Act of 2003 (<external-xref legal-doc="usc" parsable-cite="usc/22/7601">22 U.S.C. 7601</external-xref> note)
is amended by striking the item relating to section 304 and inserting the
following new item:</text>
<quoted-block display-inline="no-display-inline" id="H7A909E7DBB5F4111B9263BDDDCEF78D9" style="OLC">
<toc regeneration="no-regeneration">
<toc-entry level="section">Sec. 304. Health care partnerships to
combat
HIV/AIDS.</toc-entry>
</toc>
<after-quoted-block>.</after-quoted-block></quoted-block>
</subsection></section></subtitle><subtitle id="H7D56171D1B144DBCA1F577DA0873712D"><enum>B</enum><header>Assistance for
women, children, and families</header>
<section id="HF55D1B3B086F4607909D4700E9E940FC"><enum>311.</enum><header>Policy and
requirements</header>
<subsection id="H3B77C93128F94B94BF104F63E2838969"><enum>(a)</enum><header>Policy</header><text display-inline="yes-display-inline">Subsection (a) of section 312 of the United
States Leadership Against HIV/AIDS, Tuberculosis, and Malaria Act of 2003 (22
U.S.C. 7652) is amended—</text>
<paragraph id="H4E6324DE4EE04914A701B575A1ED25F6"><enum>(1)</enum><text display-inline="yes-display-inline">in the first sentence, by striking
<quote>The United States Government’s</quote> and inserting the
following:</text>
<quoted-block display-inline="no-display-inline" id="H18246F0988FC4FD58698592B2FAA90B9" style="OLC">
<paragraph id="H7CCA8C0A8CC24CCAA2574D593858BAD9"><enum>(1)</enum><header>In
general</header><text display-inline="yes-display-inline">The United
States</text>
</paragraph><after-quoted-block>;
and</after-quoted-block></quoted-block>
</paragraph><paragraph id="HD3EDF4573FA947EAA6E4C0927C8C51AF"><enum>(2)</enum><text>by adding at the
end the following:</text>
<quoted-block id="HCCC27B3329A94402A8F2707E82836700" style="OLC">
<paragraph id="H3200A404D1484AAC8C93DCB25922006B"><enum>(2)</enum><header>Collaboration</header><text>The
United States should work in collaboration with governments, donors, the
private sector, nongovernmental organizations, and other key stakeholders to
carry out the policy described in paragraph
(1).</text>
</paragraph><after-quoted-block>.</after-quoted-block></quoted-block>
</paragraph></subsection><subsection commented="no" id="H55433C2EBA1E42B9A745C857404BE5D3"><enum>(b)</enum><header>Requirements</header><text display-inline="yes-display-inline">Subsection (b) of such section is amended
to read as follows:</text>
<quoted-block display-inline="no-display-inline" id="H01161B59B82B4E13A3F5ABE6C2737033" style="OLC">
<subsection commented="no" id="H9C3BCEFD95294716B15B001F00F7285C"><enum>(b)</enum><header>Requirements</header><text>The
5-year United States strategy required by section 101 of this Act shall—</text>
<paragraph commented="no" id="H28685078E66D4BCCA8475D2FBAF3A0CC"><enum>(1)</enum><text>establish a target
for 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;</text>
</paragraph><paragraph commented="no" id="H498416EC3930403DAD9B96E51966C35F"><enum>(2)</enum><text>establish a target
requiring that by 2013 up to 15 percent of individuals receiving care and up to
15 percent of individuals receiving treatment under this Act and the amendments
made by this Act are children;</text>
</paragraph><paragraph commented="no" id="HE3F0A419F3CF4A88ABD2B11C79DAB021"><enum>(3)</enum><text>integrate care and
treatment with prevention of mother-to-child transmission of HIV programs in
order to improve outcomes for HIV-affected women and families as soon as is
feasible, consistent with the national government policies of countries in
which programs under this Act are administered, and including support for
strategies to ensure successful follow-up and continuity of care;</text>
</paragraph><paragraph commented="no" id="HCABB807D41C1444EB41DACF7532FF7FB"><enum>(4)</enum><text>expand programs
designed to care for children orphaned by HIV/AIDS;</text>
</paragraph><paragraph commented="no" id="H528EF4704DD942A0976B7000E2350088"><enum>(5)</enum><text>develop a timeline
for expanding access to more effective regimes to prevent mother-to-child
transmission of HIV, consistent with the national government policies of
countries in which programs under this Act are administered and the goal of
achieving universal use of such regimens as soon as possible;</text>
</paragraph><paragraph commented="no" id="H94C2B1A2F0604ABB946FC5B70A9D42B"><enum>(6)</enum><text>ensure that women
receiving voluntary contraceptive counseling, services, or commodities in
programs supported by the United States Government have access to the full
range of HIV/AIDS services; and</text>
</paragraph><paragraph id="H0406DDD04EA44FF1B101C66700C51163"><enum>(7)</enum><text display-inline="yes-display-inline">ensure that women in prevention of
mother-to-child transmission of HIV programs are provided with appropriate
maternal and child services, either directly or by
referral.</text>
</paragraph></subsection><after-quoted-block>.</after-quoted-block></quoted-block>
</subsection></section><section id="H97AC662155CA460483520844D8731CC6"><enum>312.</enum><header>Annual reports
on prevention of mother-to-child transmission of the HIV
infection</header><text display-inline="no-display-inline">Section 313(a) of
the United States Leadership Against HIV/AIDS, Tuberculosis, and Malaria Act of
2003 (<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="H06E61967137242D9A8A3DBAD9528F2B"><enum>313.</enum><header>Strategy to
prevent HIV infections among women and youth</header>
<subsection id="H1591E32394A84DF9A11999B76317B92D"><enum>(a)</enum><header>In
general</header><text display-inline="yes-display-inline">Title III of the
United States Leadership Against HIV/AIDS, Tuberculosis, and Malaria Act of
2003 (<external-xref legal-doc="usc" parsable-cite="usc/22/7631">22 U.S.C. 7631 et seq.</external-xref>) is amended by adding at the end the
following:</text>
<quoted-block display-inline="no-display-inline" id="HD1FC167B36984EA882D77F992056093" style="OLC">
<section id="H2F41BBF41F6C4867B2C07D715943B0BD"><enum>316.</enum><header>Strategy to
prevent HIV infections among women and youth</header>
<subsection id="H1A9908E5DE584CDA911612F37F859239"><enum>(a)</enum><header>Statement of
policy</header><text>In order to meet the United States Government’s goal of
preventing 12,000,000 new HIV infections worldwide, it shall be the policy of
the United States to pursue a global HIV/AIDS prevention strategy that
emphasizes the immediate and ongoing needs of women and youth and addresses the
factors that lead to gender disparities in the rate of HIV infection.</text>
</subsection><subsection id="H24A89AD7B1354D90BAD204B71304578C"><enum>(b)</enum><header>Strategy</header>
<paragraph id="HBFFE36E61F3F4D7C8E7D10F31F4E663E"><enum>(1)</enum><header>In
general</header><text>The President shall formulate a comprehensive,
integrated, and culturally-appropriate global HIV/AIDS prevention strategy
that, to the extent epidemiologically appropriate, addresses the
vulnerabilities of women and youth to HIV infection and seeks to reduce the
factors that lead to gender disparities in the rate of HIV infection.</text>
</paragraph><paragraph id="H4C2098547CCC468B843F22DB00925729"><enum>(2)</enum><header>Elements</header><text>The
strategy required under paragraph (1) shall include specific goals and targets
under the 5-year strategy outlined in section 101 and shall include
comprehensive HIV/AIDS prevention education at the individual and national
level including the ABC (<quote>Abstain, Be faithful, use Condoms</quote>)
model as a means to reduce HIV infections and shall include the
following:</text>
<subparagraph id="H6E279EAB32114358AD02F677A621BE8"><enum>(A)</enum><text>Specific goals
under the five-year strategy outlined in section 101.</text>
</subparagraph><subparagraph id="H9E62271B724D4544934660EDA11084F2"><enum>(B)</enum><text>Empowering women
and youth to avoid cross-generational sex and to decide when and whom to marry
in order to reduce the incidence of early or child marriage.</text>
</subparagraph><subparagraph id="HAC1001E302AF40C58E31F2C5BE2300EB"><enum>(C)</enum><text>Dramatically
increasing access to currently available female-controlled prevention methods
and including investments in training to increase the effective and consistent
use of both male and female condoms.</text>
</subparagraph><subparagraph id="H431B05F3278B44A5BA45836F7ED9487F"><enum>(D)</enum><text>Accelerating the
de-stigmatization of HIV/AIDS among women and youth as a major risk factor for
the transmission of HIV.</text>
</subparagraph><subparagraph id="H6F57ACA05A9148B4A400CA8E53F10000"><enum>(E)</enum><text display-inline="yes-display-inline">Addressing and preventing post-traumatic
and psycho-social consequences and providing post-exposure prophylaxis to
victims of gender-based violence and rape against women and youth through
appropriate medical, social, educational, and legal assistance and through
prosecutions and legal penalties to address such violence.</text>
</subparagraph><subparagraph id="HBACACB7FCD18407D8C9B4F2B4761FCEB"><enum>(F)</enum><text>Promoting changes
in male attitudes and behavior that respect the human rights of women and youth
and that support and foster gender equality.</text>
</subparagraph><subparagraph id="H73AE34C1BA144F46A4E1176BFA183C30"><enum>(G)</enum><text>Supporting the
development of microenterprise initiatives, job training programs, and other
such efforts to assist women in developing and retaining independent economic
means.</text>
</subparagraph><subparagraph id="H2D4019A81BF54F438E2BC8D667F89328"><enum>(H)</enum><text>Supporting
universal basic education and expanded educational opportunities for women and
youth.</text>
</subparagraph><subparagraph id="H9B792C872BC7449D888F9423B2C0A0D"><enum>(I)</enum><text>Protecting the
property and inheritance rights of women.</text>
</subparagraph><subparagraph id="H03B663BDE22E40A99EE7282D4C941934"><enum>(J)</enum><text>Coordinating
inclusion of HIV/AIDS prevention information and education services and
programs for individuals with HIV/AIDS with existing health care services
targeted to women and youth, such as ensuring access to HIV/AIDS education and
testing in family planning programs supported by the United States Government
and programs to reduce mother-to-child transmission of HIV, and expanding the
reach of such HIV/AIDS health services.</text>
</subparagraph><subparagraph id="H7D194F1635A043D3BDDB4FA89FA09EA8"><enum>(K)</enum><text>Promoting gender
equality by supporting the development of nongovernmental organizations,
including faith-based and community-based organizations, that support the needs
of women and utilizing such organizations that are already empowering women and
youth at the community level.</text>
</subparagraph><subparagraph id="HD969146A385E454A99E80073FF17EEC2"><enum>(L)</enum><text>Encouraging the
creation and effective enforcement of legal frameworks that guarantee women
equal rights and equal protection under the law.</text>
</subparagraph><subparagraph id="H582E4F5B56CC4889A8F0C3ABBD0069BC"><enum>(M)</enum><text>Encouraging the
participation and involvement of women in drafting, coordinating, and
implementing the national HIV/AIDS strategic plans of their countries.</text>
</subparagraph><subparagraph id="H7185C1D3BCC24F0993B800D2281564F7"><enum>(N)</enum><text>Responding to
other economic and social factors that increase the vulnerability of women and
youth to HIV infection.</text>
</subparagraph></paragraph><paragraph id="H7695CA1DA1F442D1B9EE66714E6935B"><enum>(3)</enum><header>Transmission to
congress and public availability</header><text display-inline="yes-display-inline">Not later than 180 days after the date of
the enactment of the Tom Lantos and Henry J. Hyde Global Leadership Against
HIV/AIDS, Tuberculosis, and Malaria Reauthorization Act of 2008, the President
shall transmit to the appropriate congressional committees and make available
to the public the strategy required under paragraph (1).</text>
</paragraph></subsection><subsection id="H9A486A614348410CBD66FD76B724C6F"><enum>(c)</enum><header>Coordination</header><text display-inline="yes-display-inline">In formulating and implementing the
strategy required under subsection (b), the President shall ensure that the
United States coordinates its overall HIV/AIDS policy and programs with the
national governments of the countries for which the United States provides
assistance to combat HIV/AIDS and, to the extent practicable, with
international organizations, other donor countries, and indigenous
organizations, including faith-based and community-based organizations
specifically for the purposes of ensuring gender equality and promoting respect
of the human rights of women that impact their susceptibility to HIV/AIDS,
improving women’s health, and expanding education for women and youth, and
organizations, including faith-based and other nonprofit organizations,
providing services to and advocating on behalf of individuals with HIV/AIDS and
individuals affected by HIV/AIDS.</text>
</subsection><subsection id="HF92A89194F464CF2A88CDC3E335D1950"><enum>(d)</enum><header>Guidance</header>
<paragraph id="HABEDDF4D25BA4CE8B53230D51D72DC4C"><enum>(1)</enum><header>In
general</header><text>The President shall provide clear guidance to field
missions of the United States Government in countries for which the United
States provides assistance to combat HIV/AIDS, based on the strategy required
under subsection (b).</text>
</paragraph><paragraph id="HBD5B734940DE41778951FAA384678F36"><enum>(2)</enum><header>Transmission to
congress and public availability</header><text display-inline="yes-display-inline">The President shall transmit to the
appropriate congressional committees and make available to the public a
description of the guidance required under paragraph (1).</text>
</paragraph></subsection><subsection id="H5317D74C834A414FBEC1F3D9DB99466"><enum>(e)</enum><header>Report</header>
<paragraph id="HB8C34D7390A1486A88A3004F95EA9BA1"><enum>(1)</enum><header>In
general</header><text display-inline="yes-display-inline">Not later than 1 year
after the date of the enactment of the Tom Lantos and Henry J. Hyde Global
Leadership Against HIV/AIDS, Tuberculosis, and Malaria Reauthorization Act of
2008, and annually thereafter as part of the annual report required under
section 104A(e) of the Foreign Assistance Act of 1961 (<external-xref legal-doc="usc" parsable-cite="usc/22/2151b-2">22 U.S.C. 2151b–2(e)</external-xref>),
the President shall transmit to the appropriate congressional committees and
make available to the public a report on the implementation of this section for
the prior fiscal year.</text>
</paragraph><paragraph id="HAFE7CBB9D3874797B9544BF2338C4200"><enum>(2)</enum><header>Matters to be
included</header><text>The report required under paragraph (1) shall include
the following:</text>
<subparagraph id="HE9685016D13044049B2EA48628434F22"><enum>(A)</enum><text>A description of
the prevention programs designed to address the vulnerabilities of women and
youth to HIV/AIDS.</text>
</subparagraph><subparagraph id="H209DA633E6BC4A9598087F6CA0AC865C"><enum>(B)</enum><text>A list of
nongovernmental organizations in each country that receive assistance from the
United States to carry out HIV prevention activities, including the amount and
the source of funding
received.</text>
</subparagraph></paragraph></subsection></section><after-quoted-block>.</after-quoted-block></quoted-block>
</subsection><subsection id="H4F5F4ECEB7D94CA6AEAB9BAEF249F74"><enum>(b)</enum><header>Clerical
amendment</header><text display-inline="yes-display-inline">The table of
contents for the United States Leadership Against HIV/AIDS, Tuberculosis, and
Malaria Act of 2003 (<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 315 the following:</text>
<quoted-block display-inline="no-display-inline" id="HA6DD0D474E15417A8556ABBE0177424C" style="OLC">
<toc regeneration="no-regeneration">
<toc-entry level="section">Sec. 316. Strategy to prevent HIV
infections among women and
youth.</toc-entry>
</toc>
<after-quoted-block>.</after-quoted-block></quoted-block>
</subsection></section><section id="HC54F07F3795D4975A9227980CBC9F650"><enum>314.</enum><header>Clerical
amendment</header><text display-inline="no-display-inline">The table of
contents for the United States Leadership Against HIV/AIDS, Tuberculosis, and
Malaria Act of 2003 (<external-xref legal-doc="usc" parsable-cite="usc/22/7601">22 U.S.C. 7601</external-xref> note) is amended by striking the item
relating to subtitle B of title III and inserting the following:</text>
<quoted-block display-inline="no-display-inline" id="H4E04B9D45B80406D92B64F3676EE0004" style="OLC">
<toc regeneration="no-regeneration">
<toc-entry level="subtitle">Subtitle B—Assistance for women,
children, and
families</toc-entry>
</toc>
<after-quoted-block>.</after-quoted-block></quoted-block>
</section></subtitle><enum>IV</enum><header>Authorization of
appropriations</header>
<section id="HC56B7804DB8D418200A51800B9789DF8"><enum>401.</enum><header>Authorization
of appropriations</header><text display-inline="no-display-inline">Section
401(a) 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(a)</external-xref>) is amended—</text>
<paragraph id="H79D8AEF5CBF6410882F6BF663C9371F6"><enum>(1)</enum><text>by striking
<quote>$3,000,000,000</quote> and inserting <quote>$10,000,000,000</quote>;
and</text>
</paragraph><paragraph id="H333C8CBE687D4963BB7E7C7802003C50"><enum>(2)</enum><text>by striking
<quote>fiscal years 2004 through 2008</quote> and inserting <quote>fiscal years
2009 through 2013</quote>.</text>
</paragraph></section><section id="H9E608E178C5B429FA064B9DC6976F208"><enum>402.</enum><header>Sense of
Congress</header><text display-inline="no-display-inline">Section 402(b) of the
United States Leadership Against HIV/AIDS, Tuberculosis, and Malaria Act of
2003 (<external-xref legal-doc="usc" parsable-cite="usc/22/7672">22 U.S.C. 7672</external-xref>) is amended—</text>
<paragraph id="H88DFA883F2564F89BB12B456470007D0"><enum>(1)</enum><text display-inline="yes-display-inline">by striking paragraph (1);</text>
</paragraph><paragraph id="HF88FCDD484634F7AB551173B7200EDF4"><enum>(2)</enum><text>by redesignating
paragraphs (2) through (4) as paragraphs (1) through (3), respectively;
and</text>
</paragraph><paragraph id="H9D4AB0699CD4432E8EC6F94B5E674F03"><enum>(3)</enum><text display-inline="yes-display-inline">in paragraph (2) (as redesignated by
paragraph (2) of this section), by striking <quote>, of which</quote> and all
that follows through <quote>programs</quote>.</text>
</paragraph></section><section id="H88E54886760B480495DF15822D77FAD"><enum>403.</enum><header>Allocation of
funds</header>
<subsection id="HA29A757E8E5749D08DC2D9595BB4F67"><enum>(a)</enum><header>HIV/AIDS
prevention activities</header><text display-inline="yes-display-inline">Subsection (a) of section 403 of the United
States Leadership Against HIV/AIDS, Tuberculosis, and Malaria Act of 2003 (22
U.S.C. 7673) is amended to read as follows:</text>
<quoted-block display-inline="no-display-inline" id="HD82F09CF5E60414D009739DE1E002522" style="OLC">
<subsection id="H59CE0BC719F44569ACA4008C05E647F8"><enum>(a)</enum><header>HIV/AIDS
prevention activities</header>
<paragraph id="H4F34E20735E548BDAD62CF6F8CC275DD"><enum>(1)</enum><header>In
general</header><text>For each of the fiscal years 2009 through 2013, not less
than 20 percent of the amounts appropriated pursuant to the authorization of
appropriations under section 401 for HIV/AIDS assistance for each such fiscal
year shall be expended for HIV/AIDS prevention activities consistent with
section 104A(d) of the Foreign Assistance Act of 1961.</text>
</paragraph><paragraph id="HA8321959FCB34087B62F017F8B0053AE"><enum>(2)</enum><header>Balanced funding
requirement</header><subparagraph commented="no" display-inline="yes-display-inline" id="H881D61598F3A48ED985100C7DB42EC36"><enum>(A)</enum><text display-inline="yes-display-inline">The Coordinator of United States Government
Activities to Combat HIV/AIDS Globally shall provide balanced funding for
prevention activities for sexual transmission of HIV/AIDS and shall ensure that
behavioral change programs, including 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><subparagraph id="H7C33FB1209C1455300EDE9BE9CA4B3FE" indent="up1"><enum>(B)</enum><text>In fulfilling the requirement under
subparagraph (A), the Coordinator shall establish a HIV sexual transmission
prevention strategy governing the expenditure of funds authorized by the Act
used to prevent the sexual transmission of HIV in any host country with a
generalized epidemic. In each such host country, if this strategy provides less
than 50 percent of such funds for behavioral change programs, including
abstinence, delay of sexual debut, monogamy, fidelity, and partner reduction,
the Coordinator shall, within 30 days of the issuance of this strategy, report
to the appropriate congressional committees on the justification for this
decision.</text>
</subparagraph><subparagraph id="HB543DC01F6714346B8C0750372BCC11" indent="up1"><enum>(C)</enum><text>Programs and activities that implement
or purchase new prevention technologies or modalities such as medical male
circumcision, pre-exposure prophylaxis, 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 this paragraph.</text>
</subparagraph></paragraph><paragraph id="H9A5AB6EDF366437FA775FD855FD55C6E"><enum>(3)</enum><header>Report</header><text>Not
later than 1 year after the date of the enactment of the Tom Lantos and Henry
J. Hyde Global Leadership Against HIV/AIDS, Tuberculosis, and Malaria
Reauthorization Act of 2008, 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 transmit to the appropriate
congressional committees and make available to the public a report on the
implementation of paragraph (2) for the prior fiscal
year.</text>
</paragraph></subsection><after-quoted-block>.</after-quoted-block></quoted-block>
</subsection><subsection id="H4C4F5CC2163A41DBA8A44E27C413CEBF"><enum>(b)</enum><header>Orphans and
vulnerable children</header><text display-inline="yes-display-inline">Subsection (b) of such section is amended
by striking <quote>fiscal years 2006 through 2008</quote> and inserting
<quote>fiscal years 2009 through 2013</quote>.</text>
</subsection></section><section commented="no" id="H37161CB0ECBD4178B9046B93C34FDB56"><enum>404.</enum><header>Prohibition on
taxation by foreign governments</header>
<subsection commented="no" id="H9D6FF9777EB54030BB6160EE41C2F352"><enum>(a)</enum><header>Prohibition on
taxation</header><text display-inline="yes-display-inline">None of the funds
appropriated pursuant to the authorization of appropriations 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>) may be made available to provide assistance for a
foreign country under a new bilateral agreement governing the terms and
conditions under which such assistance is to be provided unless such agreement
includes a provision stating that assistance provided by the United States
shall be exempt from taxation, or reimbursed, by the foreign government, and
the Secretary of State shall expeditiously seek to negotiate amendments to
existing bilateral agreements, as necessary, to conform with this
requirement.</text>
</subsection><subsection commented="no" id="H6FFED9490E734E4DA9C67872F933007D"><enum>(b)</enum><header>De minimus
exception</header><text>Foreign taxes of a de minimus nature shall not be
subject to the provisions of subsection (a).</text>
</subsection><subsection commented="no" id="HB9ACF265E4904C55AF00013EAD7357E4"><enum>(c)</enum><header>Reprogramming of
funds</header><text>Funds withheld from obligation for each country or entity
pursuant to subsection (a) shall be reprogrammed for assistance to countries
which do not assess taxes on United States assistance or which have an
effective arrangement that is providing substantial reimbursement of such
taxes.</text>
</subsection><subsection id="HCA4FD2AB575542978E00435B00F23DF"><enum>(d)</enum><header>Determinations</header>
<paragraph id="H9E680CF63AD642A7A09631327CE0E72D"><enum>(1)</enum><header>In
general</header><text display-inline="yes-display-inline">The provisions of
this section shall not apply to any country or entity the Secretary of State
determines—</text>
<subparagraph id="H2A62AF4DA726413BBBFB679C73529ECC"><enum>(A)</enum><text>does not assess
taxes on United States assistance or which has an effective arrangement that is
providing substantial reimbursement of such taxes; or</text>
</subparagraph><subparagraph id="H0BD8B81A0782419794A32FA5575136A5"><enum>(B)</enum><text>the foreign policy
interests of the United States outweigh the policy of this section to ensure
that United States assistance is not subject to taxation.</text>
</subparagraph></paragraph><paragraph id="H6E1A1EB724EA4C688705004B8BD5ED10"><enum>(2)</enum><header>Consultation</header><text>The
Secretary of State shall consult with the Committees on Foreign Affairs and
Appropriations at least 15 days prior to exercising the authority of this
subsection with regard to any country or entity.</text>
</paragraph></subsection><subsection id="H5BF780FC4F894D9D8E90DF27EBA089E9"><enum>(e)</enum><header>Implementation</header><text>The
Secretary of State shall issue rules, regulations, or policy guidance, as
appropriate, to implement the prohibition against the taxation of assistance
contained in this section.</text>
</subsection><subsection id="HB43ED018A62D4272B0A7C3C300B446AF"><enum>(f)</enum><header>Definitions</header><text>As
used in this section—</text>
<paragraph id="H146DC2B8B867424E95C67120F19D1B52"><enum>(1)</enum><text>the terms
<term>taxes</term> and <term>taxation</term> refer to value added taxes and
customs duties imposed on commodities financed with United States assistance
for programs for which funds are authorized by this Act; and</text>
</paragraph><paragraph id="H93A97F368FFD4C06887637B7E254CED"><enum>(2)</enum><text>the term
<term>bilateral agreement</term> refers to a framework bilateral agreement
between the Government of the United States and the government of the country
receiving assistance that describes the privileges and immunities applicable to
United States foreign assistance for such country generally, or an individual
agreement between the Government of the United States and such government that
describes, among other things, the treatment for tax purposes that will be
accorded the United States assistance provided under that agreement.</text>
</paragraph></subsection></section><enum>V</enum><header>Sustainability and
strengthening of health care systems</header>
<section commented="no" id="HD08C5D9EC7D34864BAB566B969AB4D8F"><enum>501.</enum><header>Sustainability
and strengthening of health care systems</header><text display-inline="no-display-inline">The United States Leadership Against
HIV/AIDS, Tuberculosis, and Malaria Act of 2003 (<external-xref legal-doc="usc" parsable-cite="usc/22/7601">22 U.S.C. 7601 et seq.</external-xref>) is
amended by adding at the end the following:</text>
<quoted-block display-inline="no-display-inline" id="H3720A406299C4F158D004906B8FB87A1" style="OLC">
<title commented="no" id="HD1531B6B4D964A0B86A3714D90C142C2"><enum>VI</enum><header>Sustainability
and strengthening of health care systems </header>
<section commented="no" id="H48827AECF39B409589A9A432B6A5863F"><enum>601.</enum><header>Findings</header><text display-inline="no-display-inline">Congress makes the following
findings:</text>
<paragraph commented="no" id="H0FAF042B62F5404EB79448A5DEB3CF78"><enum>(1)</enum><text>The shortage of
health personnel, including doctors, nurses, pharmacists, counselors,
laboratory staff, and paraprofessionals, is one of the leading obstacles to
fighting HIV/AIDS in sub-Saharan Africa.</text>
</paragraph><paragraph commented="no" id="HDC7F13D6E132434E8265A32F87EEF4F9"><enum>(2)</enum><text>The HIV/AIDS
pandemic aggravates the shortage of health workers through loss of life and
illness among medical staff, unsafe working conditions for medical personnel,
and increased workloads for diminished staff, while the shortage of health
personnel undermines efforts to prevent and provide care and treatment for
individuals with HIV/AIDS.</text>
</paragraph><paragraph commented="no" id="HB2F984522A2D4EBCAE82D9F17F7B9196"><enum>(3)</enum><text>Failure to address
the shortage of health care professionals and paraprofessionals, and the
factors forcing such individuals to leave sub-Saharan Africa, will undermine
the objectives of United States development policy and will subvert
opportunities to achieve internationally-recognized goals for the prevention,
treatment, and care of HIV/AIDS and other diseases, the reduction of child and
maternal mortality, and for economic growth and development in sub-Saharan
Africa.</text>
</paragraph></section><section commented="no" id="H1EF546DB5F32414EA23E3BF6737BDD31"><enum>602.</enum><header>National health
workforce strategies and other policies</header>
<subsection commented="no" id="H299A48B866824E3C8C27EEFB8832D011"><enum>(a)</enum><header>National health
workforce strategies</header>
<paragraph id="H6916207A3D484DACBFEFA85861D064DB"><enum>(1)</enum><header>Statement of
policy</header><text>It shall be the policy of the United States Government to
support countries receiving United States assistance to combat HIV/AIDS,
tuberculosis, and malaria, and other health programs in developing,
strengthening, and implementing 5-year health workforce strategies.</text>
</paragraph><paragraph id="H29E78C23151D4C13BA8871B8255F02BB"><enum>(2)</enum><header>Technical and
financial assistance</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, is authorized to provide technical and financial
assistance to countries described in paragraph (1) to enable such countries, in
conjunction with other funding sources, to develop, strengthen, and implement
health workforce strategies.</text>
</paragraph><paragraph commented="no" id="HA7E52369924345C184C5E990583C4D"><enum>(3)</enum><header>Activities
supported</header><text>Assistance provided under paragraph (2) shall, to the
maximum extent practicable, be used to carry out the following:</text>
<subparagraph id="HD88BCA7875794EBD829057902FC8DFE"><enum>(A)</enum><text>Activities to
promote an inclusive process that includes nongovernmental organizations and
individuals with HIV/AIDS in developing health workforce strategies.</text>
</subparagraph><subparagraph commented="no" id="H431AD3E6F3DB43339D8365008E075098"><enum>(B)</enum><text>Activities to
achieve and sustain a health workforce sufficient in numbers, skill, and
capacity to meet United States and host-country international health
commitments, including the Millennium Development Goals and universal access to
HIV/AIDS prevention, treatment, and care. In particular, such health workforce
strategies should include plans for progress toward achieving the minimum ratio
of health professionals required to achieve these goals by 2015, estimated by
the World Health Organization to require at least 2.3 doctors, nurses, and
midwives per 1,000 population, and additional health workers such as
pharmacists and lab technicians.</text>
</subparagraph><subparagraph commented="no" id="H504EC18F3014453599B7F2A3DC2F2B41"><enum>(C)</enum><text>Activities to
ensure that health workforce strategies are aimed at creating appropriate
distribution of health workers and prioritizing activities required to ensure
rural, marginalized, and other underserved populations are able to access
skilled and equipped health workers.</text>
</subparagraph><subparagraph commented="no" id="H4053D13DDB4844F0BB65DD010203EBA6"><enum>(D)</enum><text>Activities to
expand the capacity of public and private medical, nursing, pharmaceutical, and
other health training institutions.</text>
</subparagraph></paragraph></subsection><subsection commented="no" id="H824F1B3E3E5E4ACDB658015BD48F762C"><enum>(b)</enum><header>Positive broader
health impact</header><text>It shall be the policy of the United States to
ensure to expand the capacity of the health workforce engaged in HIV/AIDS
programming in ways that contribute to, and do not detract from, the capacity
of countries to meet other health needs, particularly child survival and
maternal health.</text>
</subsection><subsection commented="no" id="HB9C4D7EBA66C4927AB34D9A471C5E200"><enum>(c)</enum><header>Safety for
health workers</header><text>It is the sense of Congress that the United States
should ensure that all health workers participating in programs that receive
assistance under this Act and the amendments made by this Act have the proper
training to create safe and sanitary working conditions in accordance with
universal precautions and other forms of infection prevention and
control.</text>
</subsection><subsection commented="no" id="H7C3C7BE83E8044F0A7948023DE1F5540"><enum>(d)</enum><header>Health care for
health workers</header><text display-inline="yes-display-inline">The
Coordinator of United States Government Activities to Combat HIV/AIDS Globally
shall ensure that comprehensive and confidential health services shall be
provided to all health workers participating in programs that receive
assistance under this Act and the amendments made by this Act,
including—</text>
<paragraph id="H8F54D96E80474461B5E9009FC47302A7"><enum>(1)</enum><text>testing and
counseling for all such employees;</text>
</paragraph><paragraph id="HF5112747CA574598AB1F8853D5657434"><enum>(2)</enum><text>providing HIV/AIDS
treatment to HIV-positive employees; and</text>
</paragraph><paragraph id="H10F516C3C7294E6DA36698D72668747B"><enum>(3)</enum><text>taking measures to
reduce HIV-related stigma in the workplace.</text>
</paragraph></subsection><subsection id="HAC2A332663D14F6BB103A470F3BDAA8"><enum>(e)</enum><header>Training and
compensation finance</header><text>Where the Coordinator determines such
financial support is essential to fulfill the purposes of this Act, the
Coordinator shall finance training and provide compensation or other benefits
for health workers in order to enhance recruitment and retention of such
workers.</text>
</subsection></section><section commented="no" id="H3866624B09D644DD8073B7FDCF1E837B"><enum>603.</enum><header>Exemption of
investments in health from limits sought by international financial
institutions</header>
<subsection commented="no" id="H7451F6B0E919493C98598BA00714B77"><enum>(a)</enum><header>Coordination
within the united states government</header><text display-inline="yes-display-inline">The Coordinator of United States Government
Activities to Combat HIV/AIDS Globally shall work with the Secretary of the
Treasury to reform International Monetary Fund macroeconomic and fiscal
policies that result in limitations on national and donor investments in
health.</text>
</subsection><subsection commented="no" id="H29D74D8316E84D148F81722BFF4B948B"><enum>(b)</enum><header>Position of the
united states at the imf</header><text>The Secretary of the Treasury shall
instruct the United States Executive Director at the International Monetary
Fund to use the voice, vote, and influence of the United States to oppose any
loan, project, agreement, memorandum, instrument, plan, or other program of the
International Monetary Fund that does not exempt increased government spending
on health care from national budget caps or restraints, hiring or wage bill
ceilings, or other limits sought by any international financial
institution.</text>
</subsection></section><section commented="no" id="HF6499016E3A2416EBF99C4BCDE204CA2"><enum>604.</enum><header>Public-sector
procurement, drug registration, and supply chain management systems</header>
<subsection commented="no" id="H81A45B44369C4C3F85504518C9652133"><enum>(a)</enum><header>In
general</header><text display-inline="yes-display-inline">The Coordinator of
United States Government Activities to Combat AIDS Globally shall work with the
Partnership for Supply Chain Management Systems, host countries, and
nongovernmental organizations to develop effective, reliable host country-owned
and operated public-sector procurement and supply chain management systems,
including regional distribution, with ongoing technical assistance and
sustained support to ensure the function of such systems, as well as the
function of existing non-public sector supply chains, including those operated
by faith-based and other humanitarian organizations that procure and distribute
medical supplies.</text>
</subsection><subsection commented="no" id="H84FE941AF2A34D0F8F6B682C3EE220A8"><enum>(b)</enum><header>Availability of
equipment and supplies</header><text>The public-sector procurement and supply
chain management systems developed pursuant to subsection (a) should ensure
that adequate laboratory equipment and supplies commonly needed to fight
HIV/AIDS, including diagnostic tests for CD4 and viral load counts, x-ray
machines, mobile and facility-based rapid HIV test kits and other necessary
assays, reagents and basic supplies such as sterile syringes and gloves, are
available and distributed in a manner that is accessible to urban and rural
populations.</text>
</subsection><subsection id="H840D2C9EA68945FFBB343FA8DC7D895D"><enum>(c)</enum><header>Drug
registration</header><text display-inline="yes-display-inline">The Coordinator
shall work with host country partners and development partners to support
efficient and effective drug approval and registration systems that allow
expeditious access to safe and effective drugs, including antiretroviral
drugs.</text>
</subsection><subsection commented="no" id="H317EB46B568444A1B554DFD3966983C"><enum>(d)</enum><header>Report</header><text display-inline="yes-display-inline">The Coordinator shall submit to the
appropriate congressional committees an annual report on the implementation of
this section, including progress toward specific benchmarks established by the
Partnership for Supply Chain Management Systems, and the projection of when
host countries can fully sustain their own procurement and supply chain
management and distribution systems at a scale necessary for national primary
health needs.</text>
</subsection></section><section commented="no" id="HC18C097058E043DDA600426C8600B502"><enum>605.</enum><header>Authorization
of appropriations</header>
<subsection commented="no" id="HA26B491BA64D4E23BFC5C4698B01DB2B"><enum>(a)</enum><header>In
general</header><text display-inline="yes-display-inline">Of the amounts
authorized to be appropriated under section 401 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
title.</text>
</subsection><subsection commented="no" id="H23890C06325B4B648500AF0964A90003"><enum>(b)</enum><header>Availability</header><text>Amounts
appropriated pursuant to the authorization of appropriations under subsection
(a) are authorized to remain available until
expended.</text>
</subsection></section>.
502.The table of
contents for the United States Leadership Against HIV/AIDS, Tuberculosis, and
Malaria Act of 2003 (22 U.S.C. 7601 note) is amended by inserting after the
items relating to title V the following:
Title VI—Sustainability and strengthening of health care systems
Sec. 601. Findings.
Sec. 602. National health workforce strategies and other
policies.
Sec. 603. Exemption of investments in health from limits sought
by international financial institutions.
Sec. 604. Public-sector procurement, drug registration, and
supply chain management systems.
Sec. 605. Authorization of
appropriations.
.
Passed the House of
Representatives April 2, 2008.
Lorraine C. Miller,
Clerk.