HR 5501 ENR: Tom Lantos and Henry J. Hyde United States Global Leadership Against HIV/AIDS, Tuberculosis, and Malaria Reauthorization Act of 2008
U.S. House of Representatives
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1.Short title; table of contents
(a)This Act may be cited as the Tom Lantos and Henry J. Hyde United States Global Leadership Against HIV/AIDS, Tuberculosis, and Malaria Reauthorization Act of 2008
.
(b)The table of contents for this Act is as follows:
Sec. 1. Short title; table of contents.
Sec. 2. Findings.
Sec. 3. Definitions.
Sec. 4. Purpose.
Sec. 5. Authority to consolidate and combine reports.
TITLE I—Policy Planning and Coordination
Sec. 101. Development of an updated, comprehensive, 5-year, global strategy.
Sec. 102. Interagency working group.
Sec. 103. Sense of Congress.
TITLE II—Support for multilateral funds, programs, and public-private partnerships
Sec. 201. Voluntary contributions to international vaccine funds.
Sec. 202. Participation in the Global Fund to Fight AIDS, Tuberculosis and Malaria.
Sec. 203. Research on methods for women to prevent transmission of HIV and other diseases.
Sec. 204. Combating HIV/AIDS, tuberculosis, and malaria by strengthening health policies and health systems of partner countries.
Sec. 205. Facilitating effective operations of the Centers for Disease Control.
Sec. 206. Facilitating vaccine development.
TITLE III—Bilateral Efforts
Subtitle A—General Assistance and Programs
Sec. 301. Assistance to combat HIV/AIDS.
Sec. 302. Assistance to combat tuberculosis.
Sec. 303. Assistance to combat malaria.
Sec. 304. Malaria Response Coordinator.
Sec. 305. Amendment to Immigration and Nationality Act.
Sec. 306. Clerical amendment.
Sec. 307. Requirements.
Sec. 308. Annual report on prevention of mother-to-child transmission of HIV.
Sec. 309. Prevention of mother-to-child transmission expert panel.
TITLE IV—Funding allocations
Sec. 401. Authorization of appropriations.
Sec. 402. Sense of Congress.
Sec. 403. Allocation of funds.
TITLE V—Miscellaneous
Sec. 501. Machine readable visa fees.
TITLE VI—Emergency plan for Indian safety and health
Sec. 601. Emergency plan for Indian safety and health.
2.Section 2 of the United States Leadership Against HIV/AIDS, Tuberculosis, and Malaria Act of 2003 (22 U.S.C. 7601) is amended by adding at the end the following:
(29)On May 27, 2003, the President signed this Act into law, launching the largest international public health program of its kind ever created.
(30)Between 2003 and 2008, the United States, through the President’s Emergency Plan for AIDS Relief (PEPFAR) and in conjunction with other bilateral programs and the multilateral Global Fund has helped to—
(A)provide antiretroviral therapy for over 1,900,000 people;
(B)ensure that over 150,000 infants, most of whom would have likely been infected with HIV during pregnancy or childbirth, were not infected; and
(C)provide palliative care and HIV prevention assistance to millions of other people.
(31)While United States leadership in the battles against HIV/AIDS, tuberculosis, and malaria has had an enormous impact, these diseases continue to take a terrible toll on the human race.
(32)According to the 2007 AIDS Epidemic Update of the Joint United Nations Programme on HIV/AIDS (UNAIDS)—
(A)an estimated 2,100,000 people died of AIDS-related causes in 2007; and
(B)an estimated 2,500,000 people were newly infected with HIV during that year.
(33)According to the World Health Organization, malaria kills more than 1,000,000 people per year, 70 percent of whom are children under 5 years of age.
(34)According to the World Health Organization, 1/3 of the world’s population is infected with the tuberculosis bacterium, and tuberculosis is 1 of the greatest infectious causes of death of adults worldwide, killing 1,600,000 people per year.
(35)Efforts to promote abstinence, fidelity, the correct and consistent use of condoms, the delay of sexual debut, and the reduction of concurrent sexual partners represent important elements of strategies to prevent the transmission of HIV/AIDS.
(36)According to UNAIDS—
(A)women and girls make up nearly 60 percent of persons in sub-Saharan Africa who are HIV positive;
(B)women and girls are more biologically, economically, and socially vulnerable to HIV infection; and
(C)gender issues are critical components in the effort to prevent HIV/AIDS and to care for those affected by the disease.
(37)Children who have lost a parent to HIV/AIDS, who are otherwise directly affected by the disease, or who live in areas of high HIV prevalence may be vulnerable to the disease or its socioeconomic effects.
(38)Lack of health capacity, including insufficient personnel and inadequate infrastructure, in sub-Saharan Africa and other regions of the world is a critical barrier that limits the effectiveness of efforts to combat HIV/AIDS, tuberculosis, and malaria, and to achieve other global health goals.
(39)On March 30, 2007, the Institute of Medicine of the National Academies released a report entitled PEPFAR Implementation: Progress and Promise
, which found that budget allocations setting percentage levels for spending on prevention, care, and treatment and for certain subsets of activities within the prevention category—
(A)have adversely affected implementation of the U.S. Global AIDS Initiative
;
(B)have inhibited comprehensive, integrated, evidence based approaches;
(C)have been counterproductive
;
(D)may have been helpful initially in ensuring a balance of attention to activities within the 4 categories of prevention, treatment, care, and orphans and vulnerable children
;
(E)have also limited PEPFAR’s ability to tailor its activities in each country to the local epidemic and to coordinate with the level of activities in the countries’ national plans
; and
(F)should be removed by Congress and replaced with more appropriate mechanisms that—
(i)ensure accountability for results from Country Teams to the U.S. Global AIDS Coordinator and to Congress
; and
(ii)ensure that spending is directly linked to and commensurate with necessary efforts to achieve both country and overall performance targets for prevention, treatment, care, and orphans and vulnerable children
.
(40)The United States Government has endorsed the principles of harmonization in coordinating efforts to combat HIV/AIDS commonly referred to as the Three Ones
, which includes—
(A)1 agreed HIV/AIDS action framework that provides the basis for coordination of the work of all partners;
(B)1 national HIV/AIDS coordinating authority, with a broadbased multisectoral mandate; and
(C)1 agreed HIV/AIDS country-level monitoring and evaluating system.
(41)In the Abuja Declaration on HIV/AIDS, Tuberculosis and Other Related Infectious Diseases, of April 26–27, 2001 (referred to in this Act as the Abuja Declaration
), the Heads of State and Government of the Organization of African Unity (OAU)—
(A)declared that they would place the fight against HIV/AIDS at the forefront and as the highest priority issue in our respective national development plans
;
(B)committed TO TAKE PERSONAL RESPONSIBILITY AND PROVIDE LEADERSHIP for the activities of the National AIDS Commissions/Councils
;
(C)resolved to lead from the front the battle against HIV/AIDS, Tuberculosis and Other Related Infectious Diseases by personally ensuring that such bodies were properly convened in mobilizing our societies as a whole and providing focus for unified national policymaking and programme implementation, ensuring coordination of all sectors at all levels with a gender perspective and respect for human rights, particularly to ensure equal rights for people living with HIV/AIDS
; and
(D)pledged to set a target of allocating at least 15% of our annual budget to the improvement of the health sector
..
3.Section 3 of the United States Leadership Against HIV/AIDS, Tuberculosis, and Malaria Act of 2003 (22 U.S.C. 7602) is amended—
(1)in paragraph (2), by striking Committee on International Relations
and inserting Committee on Foreign Affairs of the House of Representatives, the Committee on Appropriations of the Senate, and the Committee on Appropriations
;
(2)by redesignating paragraph (6) as paragraph (12);
(3)by redesignating paragraphs (3) through (5), as paragraphs (4) through (6), respectively;
(4)by inserting after paragraph (2) the following:
(3)The term Global AIDS Coordinator means the Coordinator of United States Government Activities to Combat HIV/AIDS Globally.; and
(5)by inserting after paragraph (6), as redesignated, the following:
(7)Impact evaluation researchThe term impact evaluation research means the application of research methods and statistical analysis to measure the extent to which change in a population-based outcome can be attributed to program intervention instead of other environmental factors.
(8)The term operations research means the application of social science research methods, statistical analysis, and other appropriate scientific methods to judge, compare, and improve policies and program outcomes, from the earliest stages of defining and designing programs through their development and implementation, with the objective of the rapid dissemination of conclusions and concrete impact on programming.
(9)The term paraprofessional means an individual who is trained and employed as a health agent for the provision of basic assistance in the identification, prevention, or treatment of illness or disability.
(10)The term partner government means a government with which the United States is working to provide assistance to combat HIV/AIDS, tuberculosis, or malaria on behalf of people living within the jurisdiction of such government.
(11)The term program monitoring means the collection, analysis, and use of routine program data to determine—
(A)how well a program is carried out; and
(B)how much the program costs..
4.Section 4 of the United States Leadership Against HIV/AIDS, Tuberculosis, and Malaria Act of 2003 (22 U.S.C. 7603) is amended to read as follows:
4.The purpose of this Act is to strengthen and enhance United States leadership and the effectiveness of the United States response to the HIV/AIDS, tuberculosis, and malaria pandemics and other related and preventable infectious diseases as part of the overall United States health and development agenda by—
(1)establishing comprehensive, coordinated, and integrated 5-year, global strategies to combat HIV/AIDS, tuberculosis, and malaria by—
(A)building on progress and successes to date;
(B)improving harmonization of United States efforts with national strategies of partner governments and other public and private entities; and
(C)emphasizing capacity building initiatives in order to promote a transition toward greater sustainability through the support of country-driven efforts;
(2)providing increased resources for bilateral and multilateral efforts to fight HIV/AIDS, tuberculosis, and malaria as integrated components of United States development assistance;
(3)intensifying efforts to—
(A)prevent HIV infection;
(B)ensure the continued support for, and expanded access to, treatment and care programs;
(C)enhance the effectiveness of prevention, treatment, and care programs; and
(D)address the particular vulnerabilities of girls and women;
(4)encouraging the expansion of private sector efforts and expanding public-private sector partnerships to combat HIV/AIDS, tuberculosis, and malaria;
(5)reinforcing efforts to—
(A)develop safe and effective vaccines, microbicides, and other prevention and treatment technologies; and
(B)improve diagnostics capabilities for HIV/AIDS, tuberculosis, and malaria; and
(6)helping partner countries to—
(A)strengthen health systems;
(B)expand health workforce; and
(C)address infrastructural weaknesses..
5.Authority to consolidate and combine reportsSection 5 of the United States Leadership Against HIV/AIDS, Tuberculosis, and Malaria Act of 2003 (22 U.S.C. 7604) is amended by inserting , with the exception of the 5-year strategy
before the period at the end.
<enum>I</enum><header>Policy Planning and Coordination</header>
<section id="H3748CF44504D4D1584FDE2EA8057AD80"><enum>101.</enum><header>Development of an updated, comprehensive, 5-year, global strategy</header>
<subsection id="HB9B2BED31FCA4CBA8CDA47F039DD9189"><enum>(a)</enum><header>Strategy</header><text>Section 101(a) of the <short-title>United States Leadership Against HIV/AIDS, Tuberculosis, and Malaria Act of 2003</short-title> (<external-xref legal-doc="usc" parsable-cite="usc/22/7611">22 U.S.C. 7611(a)</external-xref>) is amended to read as follows:</text>
<quoted-block display-inline="no-display-inline" id="H51259D25DFB2460A9DCD19C1ADCE5B23" style="OLC">
<subsection id="H0ACB284726A84ABFA9552CAE9536DAE0"><enum>(a)</enum><header>Strategy</header><text>The President shall establish a comprehensive, integrated, 5-year strategy to expand and improve efforts to combat global HIV/AIDS. This strategy shall—</text>
<paragraph id="H8397404788EE4EC4BE90E100AA7B705"><enum>(1)</enum><text>further strengthen the capability of the United States to be an effective leader of the international campaign against this disease and strengthen the capacities of nations experiencing HIV/AIDS epidemics to combat this disease;</text></paragraph>
<paragraph id="HF0A8CC2ADADD422DBA109621FF00C67F"><enum>(2)</enum><text>maintain sufficient flexibility and remain responsive to—</text>
<subparagraph id="H2C86413600AD46AC9E009B405DAB9EA6"><enum>(A)</enum><text>changes in the epidemic;</text></subparagraph>
<subparagraph id="H57B3027A8445445CA3ECA1EEBD3A29C"><enum>(B)</enum><text>challenges facing partner countries in developing and implementing an effective national response; and</text></subparagraph>
<subparagraph id="H8651FE1B6C92462986E00600F732C110"><enum>(C)</enum><text>evidence-based improvements and innovations in the prevention, care, and treatment of HIV/AIDS;</text></subparagraph></paragraph>
<paragraph id="H9E6F1CF4B7034188A98686762836EAE8"><enum>(3)</enum><text>situate United States efforts to combat HIV/AIDS, tuberculosis, and malaria within the broader United States global health and development agenda, establishing a roadmap to link investments in specific disease programs to the broader goals of strengthening health systems and infrastructure and to integrate and coordinate HIV/AIDS, tuberculosis, or malaria programs with other health or development programs, as appropriate;</text></paragraph>
<paragraph id="H0BE3C311A5CF493A85ADFB8783617252"><enum>(4)</enum><text>provide a plan to—</text>
<subparagraph id="HD8042E4F8BAE4CE09756534FE0070D0"><enum>(A)</enum><text>prevent 12,000,000 new HIV infections worldwide;</text></subparagraph>
<subparagraph id="H9894C74BB87C459487C301D2BE15938C"><enum>(B)</enum><text>support—</text>
<clause id="H9576B2582EBF41548CB4B7C996F2F4EA"><enum>(i)</enum><text>the increase in the number of individuals with HIV/AIDS receiving antiretroviral treatment above the goal established under section 402(a)(3) and increased pursuant to paragraphs (1) through (3) of section 403(d); and</text></clause>
<clause id="H25C39ABB94F34475A100B279552524F"><enum>(ii)</enum><text>additional treatment through coordinated multilateral efforts;</text></clause></subparagraph>
<subparagraph id="HB17F528CC8E045E6AE45A04C5954CC"><enum>(C)</enum><text>support care for 12,000,000 individuals infected with or affected by HIV/AIDS, including 5,000,000 orphans and vulnerable children affected by HIV/AIDS, with an emphasis on promoting a comprehensive, coordinated system of services to be integrated throughout the continuum of care;</text></subparagraph>
<subparagraph id="H79FBB54A7DFD4B83AD14DD2BEDD4967E"><enum>(D)</enum><text>help partner countries in the effort to achieve goals of 80 percent access to counseling, testing, and treatment to prevent the transmission of HIV from mother to child, emphasizing a continuum of care model;</text></subparagraph>
<subparagraph id="HC84DF593FBE84B3ABF112200D5F8A002"><enum>(E)</enum><text>help partner countries to provide care and treatment services to children with HIV in proportion to their percentage within the HIV-infected population in each country;</text></subparagraph>
<subparagraph id="H2EEFEB515ADE4C1C8C71C8FA45D2E507"><enum>(F)</enum><text>promote preservice training for health professionals designed to strengthen the capacity of institutions to develop and implement policies for training health workers to combat HIV/AIDS, tuberculosis, and malaria;</text></subparagraph>
<subparagraph id="H2A72DEE7F8A34817B0D41ED4D221E26F"><enum>(G)</enum><text>equip teachers with skills needed for HIV/AIDS prevention and support for persons with, or affected by, HIV/AIDS;</text></subparagraph>
<subparagraph id="H74B4C4407E5143B39796DD1EEABB8D6C"><enum>(H)</enum><text>provide and share best practices for combating HIV/AIDS with health professionals;</text></subparagraph>
<subparagraph id="HBE6ABBBF3D6045DFB4021495AEB53C37"><enum>(I)</enum><text>promote pediatric HIV/AIDS training for physicians, nurses, and other health care workers, through public-private partnerships if possible, including through the designation, if appropriate, of centers of excellence for training in pediatric HIV/AIDS prevention, care, and treatment in partner countries; and</text></subparagraph>
<subparagraph id="HD42C0D8C4BDB4A0AB78FE9D42756804E"><enum>(J)</enum><text>help partner countries to train and support retention of health care professionals and paraprofessionals, with the target of training and retaining at least 140,000 new health care professionals and paraprofessionals with an emphasis on training and in country deployment of critically needed doctors and nurses and to strengthen capacities in developing countries, especially in sub-Saharan Africa, to deliver primary health care with the objective of helping countries achieve staffing levels of at least 2.3 doctors, nurses, and midwives per 1,000 population, as called for by the World Health Organization;</text></subparagraph></paragraph>
<paragraph id="HE3C4806B03CF469A9B9FEE7C17A8D46F"><enum>(5)</enum><text>include multisectoral approaches and specific strategies to treat individuals infected with HIV/AIDS and to prevent the further transmission of HIV infections, with a particular focus on the needs of families with children (including the prevention of mother-to-child transmission), women, young people, orphans, and vulnerable children;</text></paragraph>
<paragraph id="HAE62044B31954DD5007B2545916BA100"><enum>(6)</enum><text>establish a timetable with annual global treatment targets with country-level benchmarks for antiretroviral treatment;</text></paragraph>
<paragraph id="H04763B1394274CA1BC344E00293F5D35"><enum>(7)</enum><text>expand the integration of timely and relevant research within the prevention, care, and treatment of HIV/AIDS;</text></paragraph>
<paragraph id="HB4739BE4805E416B9B6FB6ADE577A0F3"><enum>(8)</enum><text>include a plan for program monitoring, operations research, and impact evaluation and for the dissemination of a best practices report to highlight findings;</text></paragraph>
<paragraph id="HB6761471816C4D56BB401DF755068D6"><enum>(9)</enum><text>support the in-country or intra-regional training, preferably through public-private partnerships, of scientific investigators, managers, and other staff who are capable of promoting the systematic uptake of clinical research findings and other evidence-based interventions into routine practice, with the goal of improving the quality, effectiveness, and local leadership of HIV/AIDS health care;</text></paragraph>
<paragraph id="HC892A9A7EDF84F8B924BC5FF4BAC6B6F"><enum>(10)</enum><text>expand and accelerate research on and development of HIV/AIDS prevention methods for women, including enhancing inter-agency collaboration, staffing, and organizational infrastructure dedicated to microbicide research;</text></paragraph>
<paragraph id="H6A5DA6F29A3941678E47A0F5D75161C6"><enum>(11)</enum><text>provide for consultation with local leaders and officials to develop prevention strategies and programs that are tailored to the unique needs of each country and community and targeted particularly toward those most at risk of acquiring HIV infection;</text></paragraph>
<paragraph id="HC2CB045C482C444899B98549A66F958B"><enum>(12)</enum><text>make the reduction of HIV/AIDS behavioral risks a priority of all prevention efforts by—</text>
<subparagraph id="H05FA1DE2DDE54BE3A24CED9000D51F99"><enum>(A)</enum><text>promoting abstinence from sexual activity and encouraging monogamy and faithfulness;</text></subparagraph>
<subparagraph id="H0D4D5390667041E994D69E4C581549A"><enum>(B)</enum><text>encouraging the correct and consistent use of male and female condoms and increasing the availability of, and access to, these commodities;</text></subparagraph>
<subparagraph id="H6B4B60370444467BA920B8D6CE54E4EC"><enum>(C)</enum><text>promoting the delay of sexual debut and the reduction of multiple concurrent sexual partners;</text></subparagraph>
<subparagraph id="H8EBD0F2A395B46C88F86F106D77CD800"><enum>(D)</enum><text>promoting education for discordant couples (where an individual is infected with HIV and the other individual is uninfected or whose status is unknown) about safer sex practices;</text></subparagraph>
<subparagraph id="HE890D71FCA6A4EB4BEB10948D324E456"><enum>(E)</enum><text>promoting voluntary counseling and testing, addiction therapy, and other prevention and treatment tools for illicit injection drug users and other substance abusers;</text></subparagraph>
<subparagraph id="HBC3E31DF644048869C003B619776DA99"><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="HB0D933647D954753A2049E224B6E75B7"><enum>(G)</enum><text>supporting partner country and community efforts to identify and address social, economic, or cultural factors, such as migration, urbanization, conflict, gender-based violence, lack of empowerment for women, and transportation patterns, which directly contribute to the transmission of HIV;</text></subparagraph>
<subparagraph id="H0E4C3C5F4B374CD4B79200498EC93D46"><enum>(H)</enum><text>supporting comprehensive programs to promote alternative livelihoods, safety, and social reintegration strategies for commercial sex workers and their families;</text></subparagraph>
<subparagraph id="H73D858CD0D4948B1864FBFD202CF200"><enum>(I)</enum><text>promoting cooperation with law enforcement to prosecute offenders of trafficking, rape, and sexual assault crimes with the goal of eliminating such crimes; and</text></subparagraph>
<subparagraph id="HBCF37A32AA1F4DD989384F1F8100AF1B"><enum>(J)</enum><text>working to eliminate rape, gender-based violence, sexual assault, and the sexual exploitation of women and children;</text></subparagraph></paragraph>
<paragraph commented="no" id="HB045D50C819640C1AD97817F3CA12B79"><enum>(13)</enum><text>include programs to reduce the transmission of HIV, particularly addressing the heightened vulnerabilities of women and girls to HIV in many countries; and</text></paragraph>
<paragraph id="H915E7864A6984BC9BEE9344F9E12BEA3"><enum>(14)</enum><text>support other important means of preventing or reducing the transmission of HIV, including—</text>
<subparagraph id="HB46CF5D63644485A80C1E0E3239D1FD1"><enum>(A)</enum><text>medical male circumcision;</text></subparagraph>
<subparagraph id="H60A3B1ACA2844A8CA19BCBE2F4627800"><enum>(B)</enum><text>the maintenance of a safe blood supply;</text></subparagraph>
<subparagraph id="HA43315246E2048F490DFB6CF427E21A6"><enum>(C)</enum><text>promoting universal precautions in formal and informal health care settings;</text></subparagraph>
<subparagraph id="H859C31723C3A4F19A19833263E114F3D"><enum>(D)</enum><text>educating the public to recognize and to avoid risks to contract HIV through blood exposures during formal and informal health care and cosmetic services;</text></subparagraph>
<subparagraph id="H5F050B4B377C4F79A274B895B89C2DB"><enum>(E)</enum><text>investigating suspected nosocomial infections to identify and stop further nosocomial transmission; and</text></subparagraph>
<subparagraph id="HBAE6C0D6E02A4554A505AC106C9812FF"><enum>(F)</enum><text>other mechanisms to reduce the transmission of HIV;</text></subparagraph></paragraph>
<paragraph id="H2C13D65D5CAB4CF590555C9042A71213"><enum>(15)</enum><text>increase support for prevention of mother-to-child transmission;</text></paragraph>
<paragraph id="HD04D376CEFCB4A4EB9FF54A9524C83DD"><enum>(16)</enum><text>build capacity within the public health sector of developing countries by improving health systems and public health infrastructure and developing indicators to measure changes in broader public health sector capabilities;</text></paragraph>
<paragraph id="H38164681AA6C4715B4B07450A0E5443D"><enum>(17)</enum><text>increase the coordination of HIV/AIDS programs with development programs;</text></paragraph>
<paragraph id="HA64C807C4ECC4CCA8E37A3E8F2017330"><enum>(18)</enum><text>provide a framework for expanding or developing existing or new country or regional programs, including—</text>
<subparagraph id="HBC13A3B02E2C4D59B8679ED2CBBAF800"><enum>(A)</enum><text>drafting compacts or other agreements, as appropriate;</text></subparagraph>
<subparagraph id="HDF753E354B7D4138A9A3A900E850A39F"><enum>(B)</enum><text>establishing criteria and objectives for such compacts and agreements; and</text></subparagraph>
<subparagraph id="H2B856794A9A44131A74F88C2DA1531FE"><enum>(C)</enum><text>promoting sustainability;</text></subparagraph></paragraph>
<paragraph id="H5CC62DB87CB0478CA01FF48F351300D6"><enum>(19)</enum><text>provide a plan for national and regional priorities for resource distribution and a global investment plan by region;</text></paragraph>
<paragraph id="H77C5A03E32B3451496BF32D790889B20"><enum>(20)</enum><text>provide a plan to address the immediate and ongoing needs of women and girls, which—</text>
<subparagraph id="H7592D09B6C6E4B96B39F89A9F92820A7"><enum>(A)</enum><text>addresses the vulnerabilities that contribute to their elevated risk of infection;</text></subparagraph>
<subparagraph id="HA209BE0000AE450C88FE6325D66900D9"><enum>(B)</enum><text>includes specific goals and targets to address these factors;</text></subparagraph>
<subparagraph id="H026B32841D4D4161A0713CBFF52573E8"><enum>(C)</enum><text>provides clear guidance to field missions to integrate gender across prevention, care, and treatment programs;</text></subparagraph>
<subparagraph id="H886E6AA09E5E4935B1DB96BF9AE3C36"><enum>(D)</enum><text>sets forth gender-specific indicators to monitor progress on outcomes and impacts of gender programs;</text></subparagraph>
<subparagraph id="H35832887DF99446991240635C618EC7"><enum>(E)</enum><text>supports efforts in countries in which women or orphans lack inheritance rights and other fundamental protections to promote the passage, implementation, and enforcement of such laws;</text></subparagraph>
<subparagraph id="H33FC3DBDC2AF4055B7E0094C37EAEE90"><enum>(F)</enum><text>supports life skills training, especially among women and girls, with the goal of reducing vulnerabilities to HIV/AIDS;</text></subparagraph>
<subparagraph id="HC9F7FE84D78546B582738F65933BDBFE"><enum>(G)</enum><text>addresses and prevents gender-based violence; and</text></subparagraph>
<subparagraph id="H70F46FB165D84D4EB2536CBC465F1D3F"><enum>(H)</enum><text>addresses the posttraumatic and psychosocial consequences and provides postexposure prophylaxis protecting against HIV infection to victims of gender-based violence and rape;</text></subparagraph></paragraph>
<paragraph id="H476BAC99EE1F43E5B893516650A1A7E2"><enum>(21)</enum><text>provide a plan to—</text>
<subparagraph id="H42BC5299FC0040A9BD2B02CAB81E7744"><enum>(A)</enum><text>determine the local factors that may put men and boys at elevated risk of contracting or transmitting HIV;</text></subparagraph>
<subparagraph id="HF52EF6274DBF4C8880FBD5211D8C498E"><enum>(B)</enum><text>address male norms and behaviors to reduce these risks, including by reducing alcohol abuse;</text></subparagraph>
<subparagraph id="H65CB65B390DC438B926654C9BC2C6620"><enum>(C)</enum><text>promote responsible male behavior; and</text></subparagraph>
<subparagraph id="HA325C8491CD2460D955CC7BB22C42330"><enum>(D)</enum><text>promote male participation and leadership at the community level in efforts to promote HIV prevention, reduce stigma, promote participation in voluntary counseling and testing, and provide care, treatment, and support for persons with HIV/AIDS;</text></subparagraph></paragraph>
<paragraph id="H1ACF91EC4F8D43249DE523B972C673FC"><enum>(22)</enum><text>provide a plan to address the vulnerabilities and needs of orphans and children who are vulnerable to, or affected by, HIV/AIDS;</text></paragraph>
<paragraph id="H7C2C1FE94D094B4C951CEC2609DC8D25"><enum>(23)</enum><text>encourage partner countries to develop health care curricula and promote access to training tailored to individuals receiving services through, or exiting from, existing programs geared to orphans and vulnerable children;</text></paragraph>
<paragraph id="H182A159D02E04C8A9C2FD31400BC09E9"><enum>(24)</enum><text>provide a framework to work with international actors and partner countries toward universal access to HIV/AIDS prevention, treatment, and care programs, recognizing that prevention is of particular importance;</text></paragraph>
<paragraph id="H0DD1BDE8A065470A941911009C11EF6C"><enum>(25)</enum><text>enhance the coordination of United States bilateral efforts to combat global HIV/AIDS with other major public and private entities;</text></paragraph>
<paragraph id="H50BD65FC3A204B40B596DFE06D38F5A7"><enum>(26)</enum><text>enhance the attention given to the national strategic HIV/AIDS plans of countries receiving United States assistance by—</text>
<subparagraph id="HD2C09B26859F423585682B5D3BA0AE3E"><enum>(A)</enum><text>reviewing the planning and programmatic decisions associated with that assistance; and</text></subparagraph>
<subparagraph id="H2235D5AD794F4AAEA049F86EA3D0041"><enum>(B)</enum><text>helping to strengthen such national strategies, if necessary;</text></subparagraph></paragraph>
<paragraph id="H246ADA41F1094D79A6D87DA526C269BA"><enum>(27)</enum><text>support activities described in the Global Plan to Stop TB, including—</text>
<subparagraph id="HEF5C7735E512475DA5901442D85576ED"><enum>(A)</enum><text>expanding and enhancing the coverage of the Directly Observed Treatment Short-course (DOTS) in order to treat individuals infected with tuberculosis and HIV, including multi-drug resistant or extensively drug resistant tuberculosis; and</text></subparagraph>
<subparagraph id="HC8A1FDCAD2E44054BEADA57CB141D5C4"><enum>(B)</enum><text>improving coordination and integration of HIV/AIDS and tuberculosis programming;</text></subparagraph></paragraph>
<paragraph id="H6816994FB57E4B2CAABCBF75F55B1D46"><enum>(28)</enum><text>ensure coordination between the Global AIDS Coordinator and the Malaria Coordinator and address issues of comorbidity between HIV/AIDS and malaria; and</text></paragraph>
<paragraph id="H8AACBB07822841F2BF45242C5B471CA9"><enum>(29)</enum><text>include a longer term estimate of the projected resource needs, progress toward greater sustainability and country ownership of HIV/AIDS programs, and the anticipated role of the United States in the global effort to combat HIV/AIDS during the 10-year period beginning on October 1, 2013.</text></paragraph></subsection><after-quoted-block>.</after-quoted-block></quoted-block></subsection>
<subsection id="HA91FCFCBA2B942F3B7BA47E23330FA71"><enum>(b)</enum><header>Report</header><text>Section 101(b) of such Act (<external-xref legal-doc="usc" parsable-cite="usc/22/7611">22 U.S.C. 7611(b)</external-xref>) is amended to read as follows:</text>
<quoted-block display-inline="no-display-inline" id="HF6AF1D0F508F4C1DAE8983BB9C00C013" style="OLC">
<subsection id="H688114814E3549B1B1E8A0C7102E408D"><enum>(b)</enum><header>Report</header>
<paragraph id="H44DF15F84F584DF099BA786E5523E94E"><enum>(1)</enum><header>In general</header><text>Not later than October 1, 2009, the President shall submit a report to the appropriate congressional committees that sets forth the strategy described in subsection (a).</text></paragraph>
<paragraph id="HD944B91246B04E81AC14DB242F915173"><enum>(2)</enum><header>Contents</header><text>The report required under paragraph (1) shall include a discussion of the following elements:</text>
<subparagraph id="H2B10027BE14E418E9030D51FA0B27F3B"><enum>(A)</enum><text>The purpose, scope, methodology, and general and specific objectives of the strategy.</text></subparagraph>
<subparagraph id="HD3FB14B766C6423100A4A6BBE700F08C"><enum>(B)</enum><text>The problems, risks, and threats to the successful pursuit of the strategy.</text></subparagraph>
<subparagraph id="H9860BE2FDEE448D7ABB860175C84009F"><enum>(C)</enum><text>The desired goals, objectives, activities, and outcome-related performance measures of the strategy.</text></subparagraph>
<subparagraph id="H7A22FBB89467453A923DDF6881EC9B00"><enum>(D)</enum><text>A description of future costs and resources needed to carry out the strategy.</text></subparagraph>
<subparagraph id="H4AB98C1E251444A0B2DB37D7DD82E54"><enum>(E)</enum><text>A delineation of United States Government roles, responsibility, and coordination mechanisms of the strategy.</text></subparagraph>
<subparagraph id="H0263A4D795AC485CBEEFB609755EACB7"><enum>(F)</enum><text>A description of the strategy—</text>
<clause id="H57B97E545B234467A96B3BA973D889F2"><enum>(i)</enum><text>to promote harmonization of United States assistance with that of other international, national, and private actors as elucidated in the <quote>Three Ones</quote>; and</text></clause>
<clause id="HBBD8BF0D33524B6093DFB8DAC664E3E"><enum>(ii)</enum><text>to address existing challenges in harmonization and alignment.</text></clause></subparagraph>
<subparagraph id="H42F457033A974F76AA4DA13DC3DE3920"><enum>(G)</enum><text>A description of the manner in which the strategy will—</text>
<clause id="H361FCE31B99848F8AA24D409C886F7CD"><enum>(i)</enum><text>further the development and implementation of the national multisectoral strategic HIV/AIDS frameworks of partner governments; and</text></clause>
<clause id="HFE460A3894374BDE9DCB480145A97D8E"><enum>(ii)</enum><text>enhance the centrality, effectiveness, and sustainability of those national plans.</text></clause></subparagraph>
<subparagraph id="H6814C9B15B964F7FB100B57F049F991D"><enum>(H)</enum><text>A description of how the strategy will seek to achieve the specific targets described in subsection (a) and other targets, as appropriate.</text></subparagraph>
<subparagraph id="H680793AB16BB435E88E6F3F9CA4C888"><enum>(I)</enum><text>A description of, and rationale for, the timetable for annual global treatment targets with country-level estimates of numbers of persons in need of antiretroviral treatment, country-level benchmarks for United States support for assistance for antiretroviral treatment, and numbers of persons enrolled in antiretroviral treatment programs receiving United States support. If global benchmarks are not achieved within the reporting period, the report shall include a description of steps being taken to ensure that global benchmarks will be achieved and a detailed breakdown and justification of spending priorities in countries in which benchmarks are not being met, including a description of other donor or national support for antiretroviral treatment in the country, if appropriate.</text></subparagraph>
<subparagraph id="H57B93C4AC1E841568F1100CC782EB7D"><enum>(J)</enum><text>A description of how operations research is addressed in the strategy and how such research can most effectively be integrated into care, treatment, and prevention activities in order to—</text>
<clause id="H899224914A514F0ABFDCE5832D9E67CE"><enum>(i)</enum><text>improve program quality and efficiency;</text></clause>
<clause id="H8AB2B2EA8ABA4847BEE9A74D7707AF14"><enum>(ii)</enum><text>ascertain cost effectiveness;</text></clause>
<clause id="H6BC26982826541C19BB7BA67813D9C8B"><enum>(iii)</enum><text>ensure transparency and accountability;</text></clause>
<clause id="HF41E868A0396433CBDEBA5E642E50500"><enum>(iv)</enum><text>assess population-based impact;</text></clause>
<clause id="H978B69774DBB4EB183EFEF3388D8E2A6"><enum>(v)</enum><text>disseminate findings and best practices; and</text></clause>
<clause id="HEA91EF863ADC44768740C8969C568763"><enum>(vi)</enum><text>optimize delivery of services.</text></clause></subparagraph>
<subparagraph id="H29629BFD25D9413194816C58313494A6"><enum>(K)</enum><text>An analysis of United States-assisted strategies to prevent the transmission of HIV/AIDS, including methodologies to promote abstinence, monogamy, faithfulness, the correct and consistent use of male and female condoms, reductions in concurrent sexual partners, and delay of sexual debut, and of intended monitoring and evaluation approaches to measure the effectiveness of prevention programs and ensure that they are targeted to appropriate audiences.</text></subparagraph>
<subparagraph id="H0FD86D253574448685A9CEC471A5AFF6"><enum>(L)</enum><text>Within the analysis required under subparagraph (K), an examination of additional planned means of preventing the transmission of HIV including medical male circumcision, maintenance of a safe blood supply, public education about risks to acquire HIV infection from blood exposures, promotion of universal precautions, investigation of suspected nosocomial infections and other tools.</text></subparagraph>
<subparagraph id="H1E10CE29425347C5B28536D0DE511C49"><enum>(M)</enum><text>A description of efforts to assist partner country and community to identify and address social, economic, or cultural factors, such as migration, urbanization, conflict, gender-based violence, lack of empowerment for women, and transportation patterns, which directly contribute to the transmission of HIV.</text></subparagraph>
<subparagraph id="H5796AD2548DE4F1880B7865CDB00E580"><enum>(N)</enum><text>A description of the specific targets, goals, and strategies developed to address the needs and vulnerabilities of women and girls to HIV/AIDS, including—</text>
<clause id="H7952AAC7351E489083A4D5F9AA5620A1"><enum>(i)</enum><text>activities directed toward men and boys;</text></clause>
<clause id="H41DB99DD613D4B26907DED00F22E1F7D"><enum>(ii)</enum><text>activities to enhance educational, microfinance, and livelihood opportunities for women and girls;</text></clause>
<clause id="H63221500B4514418AFA571DED09D445C"><enum>(iii)</enum><text>activities to promote and protect the legal empowerment of women, girls, and orphans and vulnerable children;</text></clause>
<clause id="H96A64EFB5F0A4F4CA57CA9CF70128CBD"><enum>(iv)</enum><text>programs targeted toward gender-based violence and sexual coercion;</text></clause>
<clause id="H3052E00758094E8E8BC28454853B00DF"><enum>(v)</enum><text>strategies to meet the particular needs of adolescents;</text></clause>
<clause id="H7010BD98DBAB46FA9B85F13B01D6C6B2"><enum>(vi)</enum><text>assistance for victims of rape, sexual abuse, assault, exploitation, and trafficking; and</text></clause>
<clause id="HEEAC01A91F9C4CD4807584D15B6348EC"><enum>(vii)</enum><text>programs to prevent alcohol abuse.</text></clause></subparagraph>
<subparagraph id="HDCA45CFBD90346C6BBB6E0AFF6C00490"><enum>(O)</enum><text>A description of strategies to address male norms and behaviors that contribute to the transmission of HIV, to promote responsible male behavior, and to promote male participation and leadership in HIV/AIDS prevention, care, treatment, and voluntary counseling and testing.</text></subparagraph>
<subparagraph id="H8C3918E548744EFEA7B85E53890B2AD"><enum>(P)</enum><text>A description of strategies—</text>
<clause id="H30E1F4AE601144AA99564551CF13B808"><enum>(i)</enum><text>to address the needs of orphans and vulnerable children, including an analysis of—</text>
<subclause id="HE5DD1AA88E624F9DAB8573FFCCE2C7BC"><enum>(I)</enum><text>factors contributing to children’s vulnerability to HIV/AIDS; and</text></subclause>
<subclause id="H0240E5E78C4E41FBAF6B33CD2C12F0BE"><enum>(II)</enum><text>vulnerabilities caused by the impact of HIV/AIDS on children and their families; and</text></subclause></clause>
<clause id="H9E9E839AA0F84642A4A3FB4ECB60749B"><enum>(ii)</enum><text>in areas of higher HIV/AIDS prevalence, to promote a community-based approach to vulnerability, maximizing community input into determining which children participate.</text></clause></subparagraph>
<subparagraph id="H575DB663439B4ACE9256D8B5A8A0B101"><enum>(Q)</enum><text>A description of capacity-building efforts undertaken by countries themselves, including adherents of the Abuja Declaration and an assessment of the impact of International Monetary Fund macroeconomic and fiscal policies on national and donor investments in health.</text></subparagraph>
<subparagraph id="HC54335CBEE6D41F992BCD8DCA86CC500"><enum>(R)</enum><text>A description of the strategy to—</text>
<clause id="H135B68FCBC004044BCE2E3AA6C4F4600"><enum>(i)</enum><text>strengthen capacity building within the public health sector;</text></clause>
<clause id="H26B956BAFA75422CB3CD766FBB8F5110"><enum>(ii)</enum><text>improve health care in those countries;</text></clause>
<clause id="H9C96BBBC7BF2479B9C17A8BB8C3BECCE"><enum>(iii)</enum><text>help countries to develop and implement national health workforce strategies;</text></clause>
<clause id="H5CB515CC32944F81A593BD36F1CC8F5"><enum>(iv)</enum><text>strive to achieve goals in training, retaining, and effectively deploying health staff;</text></clause>
<clause id="HFC248EBF1E5B4A7D99122F9B07D2D545"><enum>(v)</enum><text>promote the use of codes of conduct for ethical recruiting practices for health care workers; and</text></clause>
<clause id="H0B96A0CBC46B48E6A02FD2CA56095BBF"><enum>(vi)</enum><text>increase the sustainability of health programs.</text></clause></subparagraph>
<subparagraph id="H3439CC5394074C4586FAC3ED625C2D76"><enum>(S)</enum><text>A description of the criteria for selection, objectives, methodology, and structure of compacts or other framework agreements with countries or regional organizations, including—</text>
<clause id="HF96755D5302B420A80F2F84158073F54"><enum>(i)</enum><text>the role of civil society;</text></clause>
<clause id="H87D71246C3F44BCF91E860007CD5ECA"><enum>(ii)</enum><text>the degree of transparency;</text></clause>
<clause id="H6766CE23FA10432B873B9943212905B0"><enum>(iii)</enum><text>benchmarks for success of such compacts or agreements; and</text></clause>
<clause id="H8B0B7575D69F4728BCE7E2402B30DBAA"><enum>(iv)</enum><text>the relationship between such compacts or agreements and the national HIV/AIDS and public health strategies and commitments of partner countries.</text></clause></subparagraph>
<subparagraph id="H26430D191E3A4789ACC120AC60155F79"><enum>(T)</enum><text>A strategy to better coordinate HIV/AIDS assistance with nutrition and food assistance programs.</text></subparagraph>
<subparagraph id="H36CD08BD86C34C1F82C735B36581AE16"><enum>(U)</enum><text>A description of transnational or regional initiatives to combat regionalized epidemics in highly affected areas such as the Caribbean.</text></subparagraph>
<subparagraph id="H69431D6C05C6411CB1848ECECF7EC31B"><enum>(V)</enum><text>A description of planned resource distribution and global investment by region.</text></subparagraph>
<subparagraph id="H4C3FAEC8CCDC441FA417169B15F601AE"><enum>(W)</enum><text>A description of coordination efforts in order to better implement the Stop TB Strategy and to address the problem of coinfection of HIV/AIDS and tuberculosis and of projected challenges or barriers to successful implementation.</text></subparagraph>
<subparagraph id="HBF00EB56AE83432BABCBB98421EAE8AE"><enum>(X)</enum><text>A description of coordination efforts to address malaria and comorbidity with malaria and HIV/AIDS.</text></subparagraph></paragraph></subsection><after-quoted-block>.</after-quoted-block></quoted-block></subsection>
<subsection id="HA9799BC961AF4CEB88B7C453C66266D0"><enum>(c)</enum><header>Study</header><text>Section 101(c) of such Act (<external-xref legal-doc="usc" parsable-cite="usc/22/7611">22 U.S.C. 7611(c)</external-xref>) is amended to read as follows:</text>
<quoted-block act-name="" id="HA35FB06905774BEDA2575181A137FA06" style="OLC">
<subsection id="HE64748B9AEBD4E7EB7DCB4BC63D1BDBC"><enum>(c)</enum><header>Study of progress toward achievement of policy objectives</header>
<paragraph id="H7B99E3CD6C824BF9917E39EBC884E956"><enum>(1)</enum><header>Design and budget plan for data evaluation</header><text>The Global AIDS Coordinator shall enter into a contract with the Institute of Medicine of the National Academies that provides that not later than 18 months after the date of the enactment of the <short-title>Tom Lantos and Henry J. Hyde United States Global Leadership Against HIV/AIDS, Tuberculosis, and Malaria Reauthorization Act of 2008</short-title>, the Institute, in consultation with the Global AIDS Coordinator and other relevant parties representing the public and private sector, shall provide the Global AIDS Coordinator with a design plan and budget for the evaluation and collection of baseline and subsequent data to address the elements set forth in paragraph (2)(B). The Global AIDS Coordinator shall submit the budget and design plan to the appropriate congressional committees.</text></paragraph>
<paragraph id="HBB6D0D3FFFAE466693F386E7CFCC87FE"><enum>(2)</enum><header>Study</header>
<subparagraph id="HA60D6A1D28CE42358D7C136C966587D7"><enum>(A)</enum><header>In general</header><text>Not later than 4 years after the date of the enactment of the <short-title>Tom Lantos and Henry J. Hyde United States Global Leadership Against HIV/AIDS, Tuberculosis, and Malaria Reauthorization Act of 2008</short-title>, the Institute of Medicine of the National Academies shall publish a study that includes—</text>
<clause id="HE9EC99B8360D4BACA87CB81613A8C83F"><enum>(i)</enum><text>an assessment of the performance of United States-assisted global HIV/AIDS programs; and</text></clause>
<clause id="H6863D215AE23482BBA10C159B5251976"><enum>(ii)</enum><text>an evaluation of the impact on health of prevention, treatment, and care efforts that are supported by United States funding, including multilateral and bilateral programs involving joint operations.</text></clause></subparagraph>
<subparagraph id="H479DCD7087FD45979D05BBCD0032ACC2"><enum>(B)</enum><header>Content</header><text>The study conducted under this paragraph shall include—</text>
<clause id="H51AA25A1F0C04FE19761F58DB4E1347B"><enum>(i)</enum><text>an assessment of progress toward prevention, treatment, and care targets;</text></clause>
<clause id="H62895E023D6844A18308507BC3809C2E"><enum>(ii)</enum><text>an assessment of the effects on health systems, including on the financing and management of health systems and the quality of service delivery and staffing;</text></clause>
<clause id="H621D515378844B1481BB609500239DDD"><enum>(iii)</enum><text>an assessment of efforts to address gender-specific aspects of HIV/AIDS, including gender related constraints to accessing services and addressing underlying social and economic vulnerabilities of women and men;</text></clause>
<clause id="H7F6DA5EA634C4D0FA131B4FF9DFCE2E"><enum>(iv)</enum><text>an evaluation of the impact of treatment and care programs on 5-year survival rates, drug adherence, and the emergence of drug resistance;</text></clause>
<clause id="HA163706B171F4447AF1407DB12A57F00"><enum>(v)</enum><text>an evaluation of the impact of prevention programs on HIV incidence in relevant population groups;</text></clause>
<clause id="H00E7E25F88E947C1AB00D19B5D2D5805"><enum>(vi)</enum><text>an evaluation of the impact on child health and welfare of interventions authorized under this Act on behalf of orphans and vulnerable children;</text></clause>
<clause id="HC73F6FB4B63D46959233A153CB17729"><enum>(vii)</enum><text>an evaluation of the impact of programs and activities authorized in this Act on child mortality; and</text></clause>
<clause commented="no" display-inline="no-display-inline" id="HBCE8E7FC4CF845838F30E54D19EC30F7"><enum>(viii)</enum><text>recommendations for improving the programs referred to in subparagraph (A)(i).</text></clause></subparagraph>
<subparagraph commented="no" display-inline="no-display-inline" id="H9B3669BAE9B7454B9D412DF5E8023EB"><enum>(C)</enum><header>Methodologies</header><text>Assessments and impact evaluations conducted under the study shall utilize sound statistical methods and techniques for the behavioral sciences, including random assignment methodologies as feasible. Qualitative data on process variables should be used for assessments and impact evaluations, wherever possible.</text></subparagraph></paragraph>
<paragraph id="H622ED491651443429221B794C94F85E0"><enum>(3)</enum><header>Contract authority</header><text>The Institute of Medicine may enter into contracts or cooperative agreements or award grants to conduct the study under paragraph (2).</text></paragraph>
<paragraph id="HD0874D37C01C402E862E68134BE499AE"><enum>(4)</enum><header>Authorization of appropriations</header><text>There are authorized to be appropriated such sums as may be necessary to carry out the study under this subsection.</text></paragraph></subsection><after-quoted-block>.</after-quoted-block></quoted-block></subsection>
<subsection id="H1C59CE124C674459B190D2FA91FADDE0"><enum>(d)</enum><header>Report</header><text>Section 101 of such Act, as amended by this section, is further amended by adding at the end the following:</text>
<quoted-block act-name="" id="H7241F7F411EA4799BC7315A8B00F1CF" style="OLC">
<subsection id="H14994358842D469E8356F2E81CA32900"><enum>(d)</enum><header>Comptroller General report</header>
<paragraph id="H4C63EC54128A42F0BA90CB421938FDDE"><enum>(1)</enum><header>Report Required</header><text>Not later than 3 years after the date of the enactment of the <short-title>Tom Lantos and Henry J. Hyde United States Global Leadership Against HIV/AIDS, Tuberculosis, and Malaria Reauthorization Act of 2008</short-title>, the Comptroller General of the United States shall submit a report on the global HIV/AIDS programs of the United States to the appropriate congressional committees.</text></paragraph>
<paragraph id="HAA9EA20EB2614A1D9222BF9299B59534"><enum>(2)</enum><header>Contents</header><text>The report required under paragraph (1) shall include—</text>
<subparagraph id="H3ED1478B3A7A41F59373BCF1DAFDBE1D"><enum>(A)</enum><text>a description and assessment of the monitoring and evaluation practices and policies in place for these programs;</text></subparagraph>
<subparagraph id="H7830E3C6F894423485A3CF2803FC8D96"><enum>(B)</enum><text>an assessment of coordination within Federal agencies involved in these programs, examining both internal coordination within these programs and integration with the larger global health and development agenda of the United States;</text></subparagraph>
<subparagraph id="HBC7EAA5D928A460895046134AE13B76D"><enum>(C)</enum><text>an assessment of procurement policies and practices within these programs;</text></subparagraph>
<subparagraph id="HB9F5E8B8114D4D36AD55C3C2C856DB26"><enum>(D)</enum><text>an assessment of harmonization with national government HIV/AIDS and public health strategies as well as other international efforts;</text></subparagraph>
<subparagraph id="HD8C391EF944F48398EC6D86D3FFBA7FE"><enum>(E)</enum><text>an assessment of the impact of global HIV/AIDS funding and programs on other United States global health programming; and</text></subparagraph>
<subparagraph commented="no" display-inline="no-display-inline" id="H8BE9B09E869D4D74A1FCE1EEF72FAB07"><enum>(F)</enum><text>recommendations for improving the global HIV/AIDS programs of the United States.</text></subparagraph></paragraph></subsection>
<subsection id="HED22466A8BD34A70ABC38CB16C4C2FD"><enum>(e)</enum><header>Best practices report</header>
<paragraph id="H6DD238D6D31149199D3DD83C3FDE7851"><enum>(1)</enum><header>In general</header><text>Not later than 1 year after the date of the enactment of the <short-title>Tom Lantos and Henry J. Hyde United States Global Leadership Against HIV/AIDS, Tuberculosis, and Malaria Reauthorization Act of 2008</short-title>, and annually thereafter, the Global AIDS Coordinator shall publish a best practices report that highlights the programs receiving financial assistance from the United States that have the potential for replication or adaption, particularly at a low cost, across global AIDS programs, including those that focus on both generalized and localized epidemics.</text></paragraph>
<paragraph id="HED92404241604B09BCE3594DD98500E7"><enum>(2)</enum><header>Dissemination of findings</header>
<subparagraph id="H21264596403E4C4591CC53E70B45DDD"><enum>(A)</enum><header>Publication on Internet website</header><text>The Global AIDS Coordinator shall disseminate the full findings of the annual best practices report on the Internet website of the Office of the Global AIDS Coordinator.</text></subparagraph>
<subparagraph id="HC114FFE23E794B8AAAA200BAAA9EA3E9"><enum>(B)</enum><header>Dissemination guidance</header><text>The Global AIDS Coordinator shall develop guidance to ensure timely submission and dissemination of significant information regarding best practices with respect to global AIDS programs.</text></subparagraph></paragraph></subsection>
<subsection id="H58F45B4667794C3EBFE3E4D92D1CB264"><enum>(f)</enum><header>Inspectors general</header>
<paragraph id="H05C5161C110643EBB3EB9F7818C93B03"><enum>(1)</enum><header>Oversight plan</header>
<subparagraph id="HD94F51485D0945CBBC8B46C40E19D6F"><enum>(A)</enum><header>Development</header><text>The Inspectors General of the Department of State and Broadcasting Board of Governors, the Department of Health and Human Services, and the United States Agency for International Development shall jointly develop 5 coordinated annual plans for oversight activity in each of the fiscal years 2009 through 2013, with regard to the programs authorized under this Act and sections 104A, 104B, and 104C of the Foreign Assistance Act of 1961 (<external-xref legal-doc="usc" parsable-cite="usc/22/2151b-2">22 U.S.C. 2151b–2</external-xref>, 2151b–3, and 2151b–4).</text></subparagraph>
<subparagraph id="HE6A360A22AF94EB798573307290237B0"><enum>(B)</enum><header>Contents</header><text>The plans developed under subparagraph (A) shall include a schedule for financial audits, inspections, and performance reviews, as appropriate.</text></subparagraph>
<subparagraph id="HD324A50AB8564EAF8576005B31716DDF"><enum>(C)</enum><header>Deadline</header>
<clause id="H91C3C6155932496490FC542FF3C747D2"><enum>(i)</enum><header>Initial plan</header><text>The first plan developed under subparagraph (A) shall be completed not later than the later of—</text>
<subclause id="H9A83D031A6A7429995B7A4F5D0F70079"><enum>(I)</enum><text>September 1, 2008; or</text></subclause>
<subclause id="H881998305A414DF89DB1D31DE8F86EF6"><enum>(II)</enum><text>60 days after the date of the enactment of the <short-title>Tom Lantos and Henry J. Hyde United States Global Leadership Against HIV/AIDS, Tuberculosis, and Malaria Reauthorization Act of 2008</short-title>.</text></subclause></clause>
<clause id="HB430E3EFE1CB45108655BBE52F4E6D4"><enum>(ii)</enum><header>Subsequent plans</header><text>Each of the last four plans developed under subparagraph (A) shall be completed not later than 30 days before each of the fiscal years 2010 through 2013, respectively.</text></clause></subparagraph></paragraph>
<paragraph id="H0CCD0163DBFB41D98F468C3CDB1C8EFE"><enum>(2)</enum><header>Coordination</header><text>In order to avoid duplication and maximize efficiency, the Inspectors General described in paragraph (1) shall coordinate their activities with—</text>
<subparagraph id="H8467D38B5D2E43DF9DF207DB7F8F671"><enum>(A)</enum><text>the Government Accountability Office; and</text></subparagraph>
<subparagraph id="HDECE274600784656AF6FBE4700251140"><enum>(B)</enum><text>the Inspectors General of the Department of Commerce, the Department of Defense, the Department of Labor, and the Peace Corps, as appropriate, pursuant to the 2004 Memorandum of Agreement Coordinating Audit Coverage of Programs and Activities Implementing the President’s Emergency Plan for AIDS Relief, or any successor agreement.</text></subparagraph></paragraph>
<paragraph id="H88443015E4F5424C943E87D762585C79"><enum>(3)</enum><header>Funding</header><text>The Global AIDS Coordinator and the Coordinator of the United States Government Activities to Combat Malaria Globally shall make available necessary funds not exceeding $15,000,000 during the 5-year period beginning on October 1, 2008 to the Inspectors General described in paragraph (1) for the audits, inspections, and reviews described in that paragraph.</text></paragraph></subsection><after-quoted-block>.</after-quoted-block></quoted-block></subsection>
<subsection id="H07F87F9B91014DE485621D1D72653BE4"><enum>(e)</enum><header>Annual study; message</header><text>Section 101 of such Act, as amended by this section, is further amended by adding at the end the following:</text>
<quoted-block display-inline="no-display-inline" id="HD6A616B9A8B049689F787912C01DF3CE" style="OLC">
<subsection id="H4078F6230E9E43BBB90082F515F19B40"><enum>(g)</enum><header>Annual study</header>
<paragraph id="H361FA5BF820C4FDF00937371DAB35D68"><enum>(1)</enum><header>In general</header><text>Not later than September 30, 2009, and annually thereafter through September 30, 2013, the Global AIDS Coordinator shall complete a study of treatment providers that—</text>
<subparagraph id="H61B7D17CBCD94D1980D35F9D2C472DF1"><enum>(A)</enum><text>represents a range of countries and service environments;</text></subparagraph>
<subparagraph id="H40A9787CA8FA4DB2A1FC9D14B5C577B9"><enum>(B)</enum><text>estimates the per-patient cost of antiretroviral HIV/AIDS treatment and the care of people with HIV/AIDS not receiving antiretroviral treatment, including a comparison of the costs for equivalent services provided by programs not receiving assistance under this Act;</text></subparagraph>
<subparagraph id="H0E4713C432E74BD7965373A081FEADC"><enum>(C)</enum><text>estimates per-patient costs across the program and in specific categories of service providers, including—</text>
<clause id="H368B7C6F38614EA0BCB31F90BF8541B5"><enum>(i)</enum><text>urban and rural providers;</text></clause>
<clause id="HA0D2C44FB09E4C58A027D9885E41EBFB"><enum>(ii)</enum><text>country-specific providers; and</text></clause>
<clause id="H920A3B0A1C9E4AF7BE28BBBFF9D85000"><enum>(iii)</enum><text>other subcategories, as appropriate.</text></clause></subparagraph></paragraph>
<paragraph id="H3AC2E64909D84D47B6EB105481F5B4AF"><enum>(2)</enum><header>Publication</header><text>Not later than 90 days after the completion of each study under paragraph (1), the Global AIDS Coordinator shall make the results of such study available on a publicly accessible Web site.</text></paragraph></subsection>
<subsection id="HEA14E099FF954830BC2E2568677E61C8"><enum>(h)</enum><header>Message</header><text>The Global AIDS Coordinator shall develop a message, to be prominently displayed by each program receiving funds under this Act, that—</text>
<paragraph id="H0C07D1B4B1DF4AF7A56DD5D9D8196664"><enum>(1)</enum><text>demonstrates that the program is a commitment by citizens of the United States to the global fight against HIV/AIDS, tuberculosis, and malaria; and</text></paragraph>
<paragraph id="H69DE2E32640A4535A0B8F5386E8FCB18"><enum>(2)</enum><text>enhances awareness by program recipients that the program is an effort on behalf of the citizens of the United States.</text></paragraph></subsection><after-quoted-block>.</after-quoted-block></quoted-block></subsection></section>
<section id="H2590C9B647794D94931732ADC590BC48"><enum>102.</enum><header>Interagency working group</header><text display-inline="no-display-inline">Section 1(f)(2) of the State Department Basic Authorities Act of 1956 (<external-xref legal-doc="usc" parsable-cite="usc/22/2651a">22 U.S.C. 2651a(f)(2)</external-xref>) is amended—</text>
<paragraph id="HA3159634568B44B1A2E20082C3F11BCA"><enum>(1)</enum><text>in subparagraph (A), by inserting <quote>, partner country finance, health, and other relevant ministries,</quote> after <quote>community based organizations)</quote> each place it appears;</text></paragraph>
<paragraph id="HE26B21FB799349129D835CBA2B9E82E3"><enum>(2)</enum><text>in subparagraph (B)(ii)—</text>
<subparagraph id="HD4D9FEEB8BDB49449EDBF26C87398B0"><enum>(A)</enum><text>by striking subclauses (IV) and (V);</text></subparagraph>
<subparagraph id="H33CBC91ED19741D1B10793B3427DC632"><enum>(B)</enum><text>by inserting after subclause (III) the following:</text>
<quoted-block act-name="" id="HF12F184684A44EE9B7E45FCAFE048035" style="OLC">
<subclause id="H7167BA3BFA814BFAA66858D52900FB8D"><enum>(IV)</enum><text>Establishing an interagency working group on HIV/AIDS headed by the Global AIDS Coordinator and comprised of representatives from the United States Agency for International Development and the Department of Health and Human Services, for the purposes of coordination of activities relating to HIV/AIDS, including—</text>
<item id="HDA3F2A426736461696FDA612587D6730"><enum>(aa)</enum><text>meeting regularly to review progress in partner countries toward HIV/AIDS prevention, treatment, and care objectives;</text></item>
<item id="H06BB6EA949B745C800282235FADD254"><enum>(bb)</enum><text>participating in the process of identifying countries to consider for increased assistance based on the epidemiology of HIV/AIDS in those countries, including clear evidence of a public health threat, as well as government commitment to address the HIV/AIDS problem, relative need, and coordination and joint planning with other significant actors;</text></item>
<item id="H9DD25EE4AF72449682CD7F19F894102B"><enum>(cc)</enum><text>assisting the Coordinator in the evaluation, execution, and oversight of country operational plans;</text></item>
<item id="H6A4B9495FB364A9492EBE933411B80C1"><enum>(dd)</enum><text>reviewing policies that may be obstacles to reaching targets set forth for HIV/AIDS prevention, treatment, and care; and</text></item>
<item commented="no" display-inline="no-display-inline" id="HE18068F8A8E748CB9576576340A0FD97"><enum>(ee)</enum><text>consulting with representatives from additional relevant agencies, including the National Institutes of Health, the Health Resources and Services Administration, the Department of Labor, the Department of Agriculture, the Millennium Challenge Corporation, the Peace Corps, and the Department of Defense.</text></item></subclause>
<subclause commented="no" display-inline="no-display-inline" id="HAD0766777277474DA877B2A1FDAD38A2"><enum>(V)</enum><text>Coordinating overall United States HIV/AIDS policy and programs, including ensuring the coordination of relevant executive branch agency activities in the field, with efforts led by partner countries, and with the assistance provided by other relevant bilateral and multilateral aid agencies and other donor institutions to promote harmonization with other programs aimed at preventing and treating HIV/AIDS and other health challenges, improving primary health, addressing food security, promoting education and development, and strengthening health care systems.</text></subclause><after-quoted-block>;</after-quoted-block></quoted-block></subparagraph>
<subparagraph commented="no" display-inline="no-display-inline" id="H718A56398F9C41D2A5760093A28093AE"><enum>(C)</enum><text>by redesignating subclauses (VII) and VIII) as subclauses (IX) and (XII), respectively;</text></subparagraph>
<subparagraph id="H2C3D31726C414613862C21A931D132E8"><enum>(D)</enum><text>by inserting after subclause (VI) the following:</text>
<quoted-block act-name="" id="HAC22A8F21EB74C069ED7CBEE761469D1" style="OLC">
<subclause id="HBA76E1DBE9E04F0D9B99AB5647739F57"><enum>(VII)</enum><text>Holding annual consultations with nongovernmental organizations in partner countries that provide services to improve health, and advocating on behalf of the individuals with HIV/AIDS and those at particular risk of contracting HIV/AIDS, including organizations with members who are living with HIV/AIDS.</text></subclause>
<subclause id="HD80E99E72A754D58BB1B5CBFAAADD296"><enum>(VIII)</enum><text>Ensuring, through interagency and international coordination, that HIV/AIDS programs of the United States are coordinated with, and complementary to, the delivery of related global health, food security, development, and education.</text></subclause><after-quoted-block>;</after-quoted-block></quoted-block></subparagraph>
<subparagraph id="HD834435B00E6412DB654EDB7EFD5337E"><enum>(E)</enum><text>in subclause (IX), as redesignated by subparagraph (C)—</text>
<clause id="HA9A79D58A4A5412C9719FBFCC6523544"><enum>(i)</enum><text>by inserting <quote>Vietnam,</quote> after <quote>Uganda,</quote>;</text></clause>
<clause id="H3C8EAC3DFCA646379122D297001C4B19"><enum>(ii)</enum><text>by inserting after <quote>of 2003</quote> the following: ‘‘and other countries in which the United States is implementing HIV/AIDS programs as part of its foreign assistance program’’; and</text></clause>
<clause id="H9CC832BE84754DC18E00C5FB00845DE7"><enum>(iii)</enum><text>by adding at the end the following: <quote>In designating additional countries under this subparagraph, the President shall give priority to those countries in which there is a high prevalence of HIV or risk of significantly increasing incidence of HIV within the general population and inadequate financial means within the country.</quote>;</text></clause></subparagraph>
<subparagraph id="H844DD12453B543309895FF1196757C55"><enum>(F)</enum><text>by inserting after subclause (IX), as redesignated by subparagraph (C), the following:</text>
<quoted-block act-name="" id="HDB56992B922A423DA6A6893693265E25" style="OLC">
<subclause id="H7FC78832458445808400AAA2D87B784C"><enum>(X)</enum><text>Working with partner countries in which the HIV/AIDS epidemic is prevalent among injection drug users to establish, as a national priority, national HIV/AIDS prevention programs.</text></subclause>
<subclause id="HB8C612BE405B4DA781E1DBA014596E48"><enum>(XI)</enum><text>Working with partner countries in which the HIV/AIDS epidemic is prevalent among individuals involved in commercial sex acts to establish, as a national priority, national prevention programs, including education, voluntary testing, and counseling, and referral systems that link HIV/AIDS programs with programs to eradicate trafficking in persons and support alternatives to prostitution.</text></subclause><after-quoted-block>;</after-quoted-block></quoted-block></subparagraph>
<subparagraph id="HE6F9627DBC21423081F05493586F0264"><enum>(G)</enum><text>in subclause (XII), as redesignated by subparagraph (C), by striking <quote>funds section</quote> and inserting <quote>funds appropriated for HIV/ AIDS assistance pursuant to the authorization of appropriations under section 401 of the <short-title>United States Leadership Against HIV/AIDS, Tuberculosis, and Malaria Act of 2003</short-title> (<external-xref legal-doc="usc" parsable-cite="usc/22/7671">22 U.S.C. 7671</external-xref>)</quote>; and</text></subparagraph>
<subparagraph id="HD09D803A96984DDD9FD421F9C0EF9B02"><enum>(H)</enum><text>by adding at the end the following:</text>
<quoted-block act-name="" id="H6DF5FBDA09B5424A97BFC9A08BA03F7C" style="OLC">
<subclause id="H32043FDCAA98465C9B8D2CD8CE68677B"><enum>(XIII)</enum><text>Publicizing updated drug pricing data to inform the purchasing decisions of pharmaceutical procurement partners.</text></subclause><after-quoted-block>.</after-quoted-block></quoted-block></subparagraph></paragraph></section>
<section id="H4CA5C9AF20C44D81842EF6319EC59637"><enum>103.</enum><header>Sense of Congress</header><text display-inline="no-display-inline">Section 102 of the <short-title>United States Leadership Against HIV/AIDS, Tuberculosis, and Malaria Act of 2003</short-title> (<external-xref legal-doc="usc" parsable-cite="usc/22/7612">22 U.S.C. 7612</external-xref>) is amended by adding at the end the following:</text>
<quoted-block act-name="" id="HE3B38BF547C94F87BB5054D4D3F8E1AA" style="OLC">
<subsection id="H9C80D7DF3227414CB0FBF887A000C668"><enum>(d)</enum><header>Sense of Congress</header><text>It is the sense of Congress that—</text>
<paragraph id="H835739AF38444C7FABDB0054567ED3AC"><enum>(1)</enum><text>full-time country level coordinators, preferably with management experience, should head each HIV/AIDS country team for United States missions overseeing significant HIV/AIDS programs;</text></paragraph>
<paragraph id="HF37E2F34BA0443ADB76E1607CB137998"><enum>(2)</enum><text>foreign service nationals provide critically important services in the design and implementation of United States country-level HIV/AIDS programs and their skills and experience as public health professionals should be recognized within hiring and compensation practices; and</text></paragraph>
<paragraph id="H351E92924C154CE9AA486E8415C7D608"><enum>(3)</enum><text>staffing levels for United States country-level HIV/AIDS teams should be adequately maintained to fulfill oversight and other obligations of the positions.</text></paragraph></subsection><after-quoted-block>.</after-quoted-block></quoted-block></section>
<enum>II</enum><header>Support for multilateral funds, programs, and public-private partnerships</header>
<section id="H2DFEB5730269443290D33B1B7C75E6EF"><enum>201.</enum><header>Voluntary contributions to international vaccine funds</header><text display-inline="no-display-inline">Section 302 of the Foreign Assistance Act of 1961 (<external-xref legal-doc="usc" parsable-cite="usc/22/2222">22 U.S.C. 2222</external-xref>) is amended—</text>
<paragraph id="H038E3D63697E498AB5242315CD13D863"><enum>(1)</enum><text display-inline="yes-display-inline">by inserting after subsection (c) the following:</text>
<quoted-block display-inline="no-display-inline" id="H4D2F1AEA9C274371ACEFF09C4366C684" style="OLC">
<subsection id="HBE875876AB244BE2ADD92802FEF10D7"><enum>(d)</enum><header>Tuberculosis vaccine development programs</header><text>In addition to amounts otherwise available under this section, there are authorized to be appropriated to the President such sums as may be necessary for each of the fiscal years 2009 through 2013, which shall be used for United States contributions to tuberculosis vaccine development programs, which may include the Aeras Global TB Vaccine Foundation.</text></subsection><after-quoted-block>;</after-quoted-block></quoted-block></paragraph>
<paragraph id="HE61847EB2C9E4DBDB331D05E008FC85E"><enum>(2)</enum><text display-inline="yes-display-inline">in subsection (k)—</text>
<subparagraph id="H49C88571CD394B4CBAF12D8E8F1900CE"><enum>(A)</enum><text display-inline="yes-display-inline">by striking <quote>fiscal years 2004 through 2008</quote> and inserting <quote>fiscal years 2009 through 2013</quote>; and</text></subparagraph>
<subparagraph id="H78BC709B0543401588F6EE83E6EAA7F0"><enum>(B)</enum><text>by striking <quote>Vaccine Fund</quote> and inserting <quote>GAVI Fund</quote>.</text></subparagraph></paragraph>
<paragraph id="HC99FADB1FB3144F000AB6B2145F39B6D"><enum>(3)</enum><text>in subsection (l), by striking <quote>fiscal years 2004 through 2008</quote> and inserting <quote>fiscal years 2009 through 2013</quote>; and</text></paragraph>
<paragraph commented="no" display-inline="no-display-inline" id="H655DA4F99035425BB8D57F382DA6001E"><enum>(4)</enum><text>in subsection (m), by striking <quote>fiscal years 2004 through 2008</quote> and inserting <quote>fiscal years 2009 through 2013</quote>.</text></paragraph></section>
<section id="H0032FCAAB8B247BCBA66B95417C2239"><enum>202.</enum><header>Participation in the Global Fund to Fight AIDS, Tuberculosis and Malaria</header>
<subsection id="HF451F2ED8D494592A88C94B61B815229"><enum>(a)</enum><header>Findings; sense of Congress</header><text display-inline="yes-display-inline">Section 202(a) of the <short-title>United States Leadership Against HIV/AIDS, Tuberculosis, and Malaria Act of 2003</short-title> (<external-xref legal-doc="usc" parsable-cite="usc/22/7622">22 U.S.C. 7622(a)</external-xref>) is amended to read as follows:</text>
<quoted-block act-name="" id="H8B5B66F7D37F416E8FE600D7756B6B36" style="OLC">
<subsection id="HC92EFB1E0850419BACCF971DCCC2C5BC"><enum>(a)</enum><header>Findings; Sense of Congress</header>
<paragraph id="HE6484D345937490C932D2C906DB14BF6"><enum>(1)</enum><header>Findings</header><text>Congress makes the following findings:</text>
<subparagraph id="HFA47D841D0744BBAAE3286B98D832ED"><enum>(A)</enum><text>The establishment of the Global Fund in January 2002 is consistent with the general principles for an international AIDS trust fund first outlined by Congress in the Global AIDS and Tuberculosis Relief Act of 2000 (<external-xref legal-doc="public-law" parsable-cite="pl/106/264">Public Law 106–264</external-xref>).</text></subparagraph>
<subparagraph id="H4FA91853754647B3B4E4D0CCFA9CAB21"><enum>(B)</enum><text>The Global Fund is an innovative financing mechanism which—</text>
<clause id="H2FB08CEF84A74BBBA76B7E696E27CEB"><enum>(i)</enum><text>has made progress in many areas in combating HIV/AIDS, tuberculosis, and malaria; and</text></clause>
<clause id="HDB0981D8B58346F381D7F3935922B211"><enum>(ii)</enum><text>represents the multilateral component of this Act, extending United States efforts to more than 130 countries around the world.</text></clause></subparagraph>
<subparagraph id="H1DEE213A2E59477B9FD707FA3CFD3F43"><enum>(C)</enum><text>The Global Fund and United States bilateral assistance programs—</text>
<clause id="H3527A8AB3E814044B81B29309249A828"><enum>(i)</enum><text>are demonstrating increasingly effective coordination, with each possessing certain comparative advantages in the fight against HIV/AIDS, tuberculosis, and malaria; and</text></clause>
<clause id="HC5A0608AB4CD496700784DA15525D1B6"><enum>(ii)</enum><text>often work most effectively in concert with each other.</text></clause></subparagraph>
<subparagraph id="H7AD15BA2626142D383E8A5FC7F33DDA4"><enum>(D)</enum><text>The United States Government—</text>
<clause id="H72DA43B48C284BCFA3C2AE7100C93887"><enum>(i)</enum><text>is the largest supporter of the Global Fund in terms of resources and technical support;</text></clause>
<clause id="H36903ACFA778443AA99300380022C7B8"><enum>(ii)</enum><text>made the founding contribution to the Global Fund; and</text></clause>
<clause id="H808FE35DBC214E92A4A2A14E89F5ACC8"><enum>(iii)</enum><text>is fully committed to the success of the Global Fund as a multilateral public-private partnership.</text></clause></subparagraph></paragraph>
<paragraph commented="no" display-inline="no-display-inline" id="H33F6C11A74DE4824AA786FADD9DA4680"><enum>(2)</enum><header>Sense of Congress</header><text>It is the sense of Congress that—</text>
<subparagraph id="H61D637F39B2848FFA11BE01DCFD72CB2"><enum>(A)</enum><text>transparency and accountability are crucial to the long-term success and viability of the Global Fund;</text></subparagraph>
<subparagraph id="HFCCFD3BFA36A458585F6119F48CB3235"><enum>(B)</enum><text>the Global Fund has made significant progress toward addressing concerns raised by the Government Accountability Office by—</text>
<clause id="H1BEC10C1895943149956A22E7700B4CB"><enum>(i)</enum><text>improving risk assessment and risk management capabilities;</text></clause>
<clause id="H6497BF94572849E9AFDEF25E7C206EEC"><enum>(ii)</enum><text>providing clearer guidance for and oversight of Local Fund Agents; and</text></clause>
<clause id="HCA66E6537D8C475EAC9316EFD02879A0"><enum>(iii)</enum><text>strengthening the Office of the Inspector General for the Global Fund;</text></clause></subparagraph>
<subparagraph id="HCC92F1785AD04D7194E7AA664F7BDACD"><enum>(C)</enum><text>the provision of sufficient resources and authority to the Office of the Inspector General for the Global Fund to ensure that office has the staff and independence necessary to carry out its mandate will be a measure of the commitment of the Global Fund to transparency and accountability;</text></subparagraph>
<subparagraph id="H2116E7DB2CBF49609EC48BD6B4C1EAA0"><enum>(D)</enum><text>regular, publicly published financial, programmatic, and reporting audits of the Fund, its grantees, and Local Fund Agents are also important benchmarks of transparency;</text></subparagraph>
<subparagraph id="H19B2256B03FA472C9540A8A583A5C9F9"><enum>(E)</enum><text>the Global Fund should establish and maintain a system to track—</text>
<clause id="H5EB6AD8E11644F998F1CBA8E88C00A3"><enum>(i)</enum><text>the amount of funds disbursed to each subrecipient on the grant’s fiscal cycle; and</text></clause>
<clause id="H721FA56C8B95485082F5210076EE2EBF"><enum>(ii)</enum><text>the distribution of resources, by grant and principal recipient, for prevention, care, treatment, drug and commodity purchases, and other purposes;</text></clause></subparagraph>
<subparagraph id="H0970A089C4604B858E11B4B26758670"><enum>(F)</enum><text>relevant national authorities in recipient countries should exempt from duties and taxes all products financed by Global Fund grants and procured by any principal recipient or subrecipient for the purpose of carrying out such grants;</text></subparagraph>
<subparagraph id="H72FC4123B14A4818B7167B14A500A216"><enum>(G)</enum><text>the Global Fund, UNAIDS, and the Global AIDS Coordinator should work together to standardize program indicators wherever possible;</text></subparagraph>
<subparagraph commented="no" display-inline="no-display-inline" id="H35D0F930F83A434AB3B8D8F8F7FF9B00"><enum>(H)</enum><text>for purposes of evaluating total amounts of funds contributed to the Global Fund under subsection (d)(4)(A)(i), the timetable for evaluations of contributions from sources other than the United States should take into account the fiscal calendars of other major contributors; and</text></subparagraph>
<subparagraph id="H1216C98449074A71B467D9EB009F2422"><enum>(I)</enum><text>the Global Fund should not support activities involving the <quote>Affordable Medicines Facility-Malaria</quote> or similar entities pending compelling evidence of success from pilot programs as evaluated by the Coordinator of United States Government Activities to Combat Malaria Globally.</text></subparagraph></paragraph></subsection><after-quoted-block>.</after-quoted-block></quoted-block></subsection>
<subsection id="H39B474C23F1940B08B9255F0F0DED3C"><enum>(b)</enum><header>Statement of policy</header><text>Section 202(b) of such Act is amended by adding at the end the following:</text>
<quoted-block display-inline="no-display-inline" id="H9B455B38FCBA4358A7ED1F9788A9A6C1" style="OLC">
<paragraph id="H3F2A26C24DEA45BFA3632800B615E82F"><enum>(3)</enum><header>Statement of policy</header><text>The United States Government regards the imposition by recipient countries of taxes or tariffs on goods or services provided by the Global Fund, which are supported through public and private donations, including the substantial contribution of the American people, as inappropriate and inconsistent with standards of good governance. The Global AIDS Coordinator or other representatives of the United States Government shall work with the Global Fund to dissuade governments from imposing such duties, tariffs, or taxes.</text></paragraph><after-quoted-block>.</after-quoted-block></quoted-block></subsection>
<subsection id="H818295FD38414C93A778D225EDA5569"><enum>(c)</enum><header>United States financial participation</header><text>Section 202(d) of such Act (<external-xref legal-doc="usc" parsable-cite="usc/22/7622">22 U.S.C. 7622(d)</external-xref>) is amended—</text>
<paragraph id="H725F23FFB4834C01BB28CFD43242443B"><enum>(1)</enum><text>in paragraph (1)—</text>
<subparagraph id="H2972624D3D4F41349C4C8F6FEC58B177"><enum>(A)</enum><text>by striking <quote>$1,000,000,000 for the period of fiscal year 2004 beginning on January 1, 2004</quote> and inserting <quote>$2,000,000,000 for fiscal year 2009,</quote>; and</text></subparagraph>
<subparagraph id="H1BE4968666174319ABCDBCBA6BBCC1E6"><enum>(B)</enum><text>by striking <quote>the fiscal years 2005–2008</quote> and inserting <quote>each of the fiscal years 2010 through 2013</quote>;</text></subparagraph></paragraph>
<paragraph id="HEBDA3CEEBE814A9499F4D9032C00DF81"><enum>(2)</enum><text>in paragraph (4)—</text>
<subparagraph id="H19FFB48EF0044764A3AFC895001B2197"><enum>(A)</enum><text>in subparagraph (A)—</text>
<clause id="HD3F1CF892C6045BE96E0312400693E9D"><enum>(i)</enum><text>in clause (i), by striking <quote>fiscal years 2004 through 2008</quote> and inserting <quote>fiscal years 2009 through 2013</quote>;</text></clause>
<clause id="H7726E251BDD744D285CF137B63EB4EF0"><enum>(ii)</enum><text>in clause (ii)—</text>
<subclause id="H226A2D02D2F34A1ABEF2FD41D561A1B9"><enum>(I)</enum><text>by striking <quote>during any of the fiscal years 2004 through 2008</quote> and inserting <quote>during any of the fiscal years 2009 through 2013</quote>; and</text></subclause>
<subclause id="HB691CCEEE4BE446B8F32664513180091"><enum>(II)</enum><text>by adding at the end the following: <quote>The President may waive the application of this clause with respect to assistance for Sudan that is overseen by the Southern Country Coordinating Mechanism, including Southern Sudan, Southern Kordofan, Blue Nile State, and Abyei, if the President determines that the national interest or humanitarian reasons justify such a waiver. The President shall publish each waiver of this clause in the Federal Register and, not later than 15 days before the waiver takes effect, shall consult with the Committee on Foreign Relations of the Senate and the Committee on Foreign Affairs of the House of Representatives regarding the proposed waiver.</quote>; and</text></subclause></clause>
<clause id="HA7E705B92A154D59B7E9BA8DC80406B"><enum>(iii)</enum><text>in clause (vi)—</text>
<subclause id="H4E126156A92C46B58297714C4179174B"><enum>(I)</enum><text>by striking <quote>for the purposes</quote> and inserting <quote>For the purposes</quote>;</text></subclause>
<subclause id="HF3868BED90F74A0E8EFA8B5E67007F1B"><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="H4430BA46D9B0447B00FC6C44D8979503"><enum>(III)</enum><text>by striking <quote>prior to fiscal year 2004</quote> and inserting <quote>before fiscal year 2009</quote>;</text></subclause></clause></subparagraph>
<subparagraph id="H5244EFE28B444C7D85A154CFA1BAD5FC"><enum>(B)</enum><text>in subparagraph (B)(iv), by striking <quote>fiscal years 2004 through 2008</quote> and inserting <quote>fiscal years 2009 through 2013</quote>; and</text></subparagraph>
<subparagraph id="HB0FE9C6B711F4EF6AE808084ABC0B221"><enum>(C)</enum><text>in subparagraph (C)(ii), by striking <quote>Committee on International Relations</quote> and inserting <quote>Committee on Foreign Affairs</quote>; and</text></subparagraph></paragraph>
<paragraph id="H2322DBD8106F46A4A92D07A781803889"><enum>(3)</enum><text>by adding at the end the following:</text>
<quoted-block display-inline="no-display-inline" id="H565CB7E8D74640BF9F8290A67257E67" style="OLC">
<paragraph id="HC2432DB1020B474B00BF88516638B4C6"><enum>(5)</enum><header>Withholding funds</header><text>Notwithstanding any other provision of this Act, 20 percent of the amounts appropriated pursuant to this Act for a contribution to support the Global Fund for each of the fiscal years 2010 through 2013 shall be withheld from obligation to the Global Fund until the Secretary of State certifies to the appropriate congressional committees that the Global Fund—</text>
<subparagraph id="H1287E57C1328459185A6990056E28DD2"><enum>(A)</enum><text>has established an evaluation framework for the performance of Local Fund Agents (referred to in this paragraph as <quote>LFAs</quote>);</text></subparagraph>
<subparagraph id="H5137210FC6C84338A700C53EF4664919"><enum>(B)</enum><text>is undertaking a systematic assessment of the performance of LFAs;</text></subparagraph>
<subparagraph id="H607D84C9E0AC4CAA90D808AD69CF2456"><enum>(C)</enum><text>has adopted, and is implementing, a policy to publish on a publicly available Web site—</text>
<clause id="HD86C734BA5C64AB8B057F3E839B3007B"><enum>(i)</enum><text>grant performance reviews;</text></clause>
<clause id="HF208CB6049A84C4D9732FFAABFDC1EC"><enum>(ii)</enum><text>all reports of the Inspector General of the Global Fund, in a manner that is consistent with the Policy for Disclosure of Reports of the Inspector General, approved at the 16th Meeting of the Board of the Global Fund;</text></clause>
<clause id="HE7F8468B59C94A6292DC875724A2D7B2"><enum>(iii)</enum><text>decision points of the Board of the Global Fund;</text></clause>
<clause id="HDD7C4257877B4AED00862EB3B8E10024"><enum>(iv)</enum><text>reports from Board committees to the Board; and</text></clause>
<clause id="HE1673CC07C53483D9B005D1DE538D1DB"><enum>(v)</enum><text>a regular collection and analysis of performance data and funding of grants of the Global Fund, which shall cover all principal recipients and all subrecipients;</text></clause></subparagraph>
<subparagraph id="HFB7B75EA6E57430EAE22D9547EBA2471"><enum>(D)</enum><text>is maintaining an independent, well-staffed Office of the Inspector General that—</text>
<clause id="HBABDA93A60E043849392FD1F41FECA09"><enum>(i)</enum><text>reports directly to the Board of the Global Fund; and</text></clause>
<clause id="HB863340133EF4DB9BF00BCCBFDAF60"><enum>(ii)</enum><text>compiles regular, publicly published audits of financial, programmatic, and reporting aspects of the Global Fund, its grantees, and LFAs;</text></clause></subparagraph>
<subparagraph id="H0277CD21F7164E96A7974E183CF83935"><enum>(E)</enum><text>has established, and is reporting publicly on, standard indicators for all program areas;</text></subparagraph>
<subparagraph id="HD48ADD8C0FF246D382398730B35F4503"><enum>(F)</enum><text>has established a methodology to track and is publicly reporting on—</text>
<clause id="HCB38B79035AA45B7996060EEDE04F043"><enum>(i)</enum><text>all subrecipients and the amount of funds disbursed to each subrecipient on the grant’s fiscal cycle; and</text></clause>
<clause id="H27EAC8F998FB4703B43F0079A7580069"><enum>(ii)</enum><text>the distribution of resources, by grant and principal recipient, for prevention, care, treatment, drugs and commodities purchase, and other purposes;</text></clause></subparagraph>
<subparagraph id="HDB40150AC54143878F379495E2A63C2F"><enum>(G)</enum><text>has established a policy on tariffs imposed by national governments on all goods and services financed by the Global Fund;</text></subparagraph>
<subparagraph id="H88F25B7ED28D4CA583C20D6E9758552"><enum>(H)</enum><text>through its Secretariat, has taken meaningful steps to prevent national authorities in recipient countries from imposing taxes or tariffs on goods or services provided by the Fund;</text></subparagraph>
<subparagraph id="HC138E2376E4D4F28909CAAD3A310C55D"><enum>(I)</enum><text>is maintaining its status as a financing institution focused on programs directly related to HIV/AIDS, malaria, and tuberculosis;</text></subparagraph>
<subparagraph id="HD7660D309FE54E1880C88D29B44354A6"><enum>(J)</enum><text>is maintaining and making progress on—</text>
<clause id="HDEF4A04C581F48339B755F84002273D0"><enum>(i)</enum><text>sustaining its multisectoral approach, through country coordinating mechanisms; and</text></clause>
<clause id="HD828C3CFCE8C4B7FA6B4EC4C1E8B92FF"><enum>(ii)</enum><text>the implementation of grants, as reflected in the proportion of resources allocated to different sectors, including governments, civil society, and faith- and community-based organizations; and</text></clause></subparagraph>
<subparagraph id="H9DF97F0276B44DC38624339E40EFB4CB"><enum>(K)</enum><text>has established procedures providing access by the Office of Inspector General of the Department of State and Broadcasting Board of Governors, as cognizant Inspector General, and the Inspector General of the Health and Human Services and the Inspector General of the United States Agency for International Development, to Global Fund financial data, and other information relevant to United States contributions (as determined by the Inspector General in consultation with the Global AIDS Coordinator).</text></subparagraph></paragraph>
<paragraph commented="no" display-inline="no-display-inline" id="H0D8A234B175940A488FB7DEDCD0D2A3"><enum>(6)</enum><header display-inline="yes-display-inline">Summaries of Board decisions and United States positions</header><text display-inline="yes-display-inline">Following each meeting of the Board of the Global Fund, the Coordinator of United States Government Activities to Combat HIV/AIDS Globally shall report on the public website of the Coordinator a summary of Board decisions and how the United States Government voted and its positions on such decisions.</text></paragraph><after-quoted-block>.</after-quoted-block></quoted-block></paragraph></subsection></section>
<section display-inline="no-display-inline" id="H81F0FECB4BDF445AB7E36207EE4F2633"><enum>203.</enum><header>Research on methods for women to prevent transmission of HIV and other diseases</header>
<subsection id="HFBC5CA628816441BA6ABE747C638FA34"><enum>(a)</enum><header>Sense of Congress</header><text display-inline="yes-display-inline">Congress recognizes the need and urgency to expand the range of interventions for preventing the transmission of human immunodeficiency virus (HIV), including nonvaccine prevention methods that can be controlled by women.</text></subsection>
<subsection id="H002DF01D637D4AA78BAF7BF23B7336C6"><enum>(b)</enum><header>NIH Office of AIDS Research</header><text display-inline="yes-display-inline">Subpart 1 of part D of title XXIII of the Public Health Service Act (<external-xref legal-doc="usc" parsable-cite="usc/42/300cc-40">42 U.S.C. 300cc–40 et seq.</external-xref>) is amended by inserting after section 2351 the following:</text>
<quoted-block display-inline="no-display-inline" id="H0EFD8055A1AD4E01ABC647A1FBD37EE5" style="OLC">
<section id="HF6A7FCCE8DB94D47A568B6B4FEA492D"><enum>2351A.</enum><header>Microbicide research</header>
<subsection id="HAAAE251BB72E437DA5E8623C8F48B7F8"><enum>(a)</enum><header>Federal Strategic Plan</header><text display-inline="yes-display-inline">The Director of the Office shall—</text>
<paragraph id="H22BF25F2498D4378A0CC042F44E2CA8D"><enum>(1)</enum><text display-inline="yes-display-inline">expedite the implementation of the Federal strategic plans required by section 403(a) of the Public Health Service Act (<external-xref legal-doc="usc" parsable-cite="usc/42/283">42 U.S.C. 283(a)(5)</external-xref>) regarding the conduct and support of research on, and development of, a microbicide to prevent the transmission of the human immunodeficiency virus; and</text></paragraph>
<paragraph id="HCDFB97CD63374845A1787CE9B24FDAF2"><enum>(2)</enum><text display-inline="yes-display-inline">review and, as appropriate, revise such plan to prioritize funding and activities relative to their scientific urgency and potential market readiness.</text></paragraph></subsection>
<subsection id="H8D999848DF324573812D261D72FEBAE6"><enum>(b)</enum><header>Coordination</header><text>In implementing, reviewing, and prioritizing elements of the plan described in subsection (a), the Director of the Office shall consult, as appropriate, with—</text>
<paragraph id="HCC01F948D2784508B2E4BDD7A57095B7"><enum>(1)</enum><text display-inline="yes-display-inline">representatives of other Federal agencies involved in microbicide research, including the Coordinator of United States Government Activities to Combat HIV/AIDS Globally, the Director of the Centers for Disease Control and Prevention, and the Administrator of the United States Agency for International Development;</text></paragraph>
<paragraph id="H7889B75B0EA24DA098257EA05219EF8"><enum>(2)</enum><text>the microbicide research and development community; and</text></paragraph>
<paragraph id="H6FD32FA3C4FC473E884D48A900E15B3"><enum>(3)</enum><text>health advocates.</text></paragraph></subsection></section><after-quoted-block>.</after-quoted-block></quoted-block></subsection>
<subsection id="HCD51B552D76141E30059F0815EAFF107"><enum>(c)</enum><header>National institute of allergy and infectious diseases</header><text>Subpart 6 of part C of title IV of the Public Health Service Act (<external-xref legal-doc="usc" parsable-cite="usc/42/285f">42 U.S.C. 285f et seq.</external-xref>) is amended by adding at the end the following:</text>
<quoted-block display-inline="no-display-inline" id="HF36E53BA7AA941BC8FC469F3F90004F4" style="OLC">
<section id="H43440A6759CD479CA78D6D164CB24FC9"><enum>447C.</enum><header>Microbicide research and development</header><text display-inline="no-display-inline">The Director of the Institute, acting through the head of the Division of AIDS, shall, consistent with the peer-review process of the National Institutes of Health, carry out research on, and development of, safe and effective methods for use by women to prevent the transmission of the human immunodeficiency virus, which may include microbicides.</text></section><after-quoted-block>.</after-quoted-block></quoted-block></subsection>
<subsection id="HC411F5F4A1FE49889B0017B9D0D8FDD1"><enum>(d)</enum><header>CDC</header><text>Part B of title III of the Public Health Service Act (<external-xref legal-doc="usc" parsable-cite="usc/42/243">42 U.S.C. 243 et seq.</external-xref>) is amended by inserting after section 317S the following:</text>
<quoted-block display-inline="no-display-inline" id="H1462BB99C51948709EC4638DA1EB4B93" style="OLC">
<section id="H5F4BB7755AD6475796184C1F31806476"><enum>317T.</enum><header>Microbicide research</header>
<subsection id="H1BE7EC3E75674E2FA900EF3B6DE1A1AB"><enum>(a)</enum><header>In general</header><text>The Director of the Centers for Disease Control and Prevention is strongly encouraged to fully implement the Centers’ microbicide agenda to support research and development of microbicides for use to prevent the transmission of the human immunodeficiency virus.</text></subsection>
<subsection id="H1760C6DFC43847CC91A1B5FF297CFA3"><enum>(b)</enum><header>Authorization of appropriations</header><text>There are authorized to be appropriated such sums as may be necessary for each of fiscal years 2009 through 2013 to carry out this section.</text></subsection></section><after-quoted-block>.</after-quoted-block></quoted-block></subsection>
<subsection id="HD480549C201D4D3DACA4E1B9D541F9F8"><enum>(e)</enum><header>United States Agency for International Development</header>
<paragraph id="HB7DB3650F18548D1B6F8222BECE5F933"><enum>(1)</enum><header>In general</header><text display-inline="yes-display-inline">The Administrator of the United States Agency for International Development, in coordination with the Coordinator of United States Government Activities to Combat HIV/AIDS Globally, may facilitate availability and accessibility of microbicides, provided that such pharmaceuticals are approved, tentatively approved, or otherwise authorized for use by—</text>
<subparagraph id="H9BC02FFA43114D31ADD6144EBD614771"><enum>(A)</enum><text>the Food and Drug Administration;</text></subparagraph>
<subparagraph id="HC8541457FC304B1F98263351C00069C3"><enum>(B)</enum><text>a stringent regulatory agency acceptable to the Secretary of Health and Human Services; or</text></subparagraph>
<subparagraph id="H66D60E3C9E684676A157DCA7A2BED7DE"><enum>(C)</enum><text>a quality assurance mechanism acceptable to the Secretary of Health and Human Services.</text></subparagraph></paragraph>
<paragraph commented="no" display-inline="no-display-inline" id="H1354CF4CEA20453BBE36F09B52FBE021"><enum>(2)</enum><header>Authorization of appropriations</header><text>Of the amounts authorized to be appropriated under section 401 of the United States Leadership Against HIV/AIDS, Tuberculosis, and Malaria Act of 2003 (<external-xref legal-doc="usc" parsable-cite="usc/22/7671">22 U.S.C. 7671</external-xref>) for HIV/AIDS assistance, there are authorized to be appropriated to the President such sums as may be necessary for each of the fiscal years 2009 through 2013 to carry out this subsection.</text></paragraph></subsection></section>
<section id="H12DBA2A83AE24BA0B6BCE4C9EF111DC0"><enum>204.</enum><header>Combating HIV/AIDS, tuberculosis, and malaria by strengthening health policies and health systems of partner countries</header>
<subsection id="H93503E4CC53448ADAC567481124809E0"><enum>(a)</enum><header>In general</header><text>Title II of the <short-title>United States Leadership Against HIV/AIDS, Tuberculosis, and Malaria Act of 2003</short-title> (<external-xref legal-doc="usc" parsable-cite="usc/22/7621">22 U.S.C. 7621</external-xref>) is amended by adding at the end the following:</text>
<quoted-block display-inline="no-display-inline" id="H6EA1B8D5C39A45A8A0E0175874E95B5F" style="OLC">
<section id="H19E8AA7A8FD346B88EE469FF282FA77D"><enum>204.</enum><header>Combating HIV/AIDS, tuberculosis, and malaria by strengthening health policies and health systems of partner countries</header>
<subsection id="H1DFD7A10557749239F00F2CF6D61ED51"><enum>(a)</enum><header>Statement of policy</header><text>It shall be the policy of the United States Government—</text>
<paragraph id="HDC6E90BB9A8F47EE8F6B056D2FC07468"><enum>(1)</enum><text>to invest appropriate resources authorized under this Act—</text>
<subparagraph id="H10B3BA8A862044B59C1966A6E3D0C3C"><enum>(A)</enum><text>to carry out activities to strengthen HIV/AIDS, tuberculosis, and malaria health policies and health systems; and</text></subparagraph>
<subparagraph id="H8A479C3CB2A54C4293CEB9F3DEAF956D"><enum>(B)</enum><text>to provide workforce training and capacity-building consistent with the goals and objectives of this Act; and</text></subparagraph></paragraph>
<paragraph id="H27F6F0509CEA4E3CB071004BEFA7BB3C"><enum>(2)</enum><text>to support the development of a sound policy environment in partner countries to increase the ability of such countries—</text>
<subparagraph id="H9D2460F143304F5EB3EA9DB0E0B31163"><enum>(A)</enum><text>to maximize utilization of health care resources from donor countries;</text></subparagraph>
<subparagraph id="H93F286757E304AF29C516DE53FD9D9F0"><enum>(B)</enum><text>to increase national investments in health and education and maximize the effectiveness of such investments;</text></subparagraph>
<subparagraph id="HF92A2831333F41C693BE5F7E9CC4F717"><enum>(C)</enum><text>to improve national HIV/AIDS, tuberculosis, and malaria strategies;</text></subparagraph>
<subparagraph id="HA3D002C7B40140429D8D01F728072542"><enum>(D)</enum><text>to deliver evidence-based services in an effective and efficient manner; and</text></subparagraph>
<subparagraph id="HB0E72C8202CD4984859C3B4DE4ACD3C0"><enum>(E)</enum><text>to reduce barriers that prevent recipients of services from achieving maximum benefit from such services.</text></subparagraph></paragraph></subsection>
<subsection id="H4E194D10DD7D4B108CB2FB58D9848B6D"><enum>(b)</enum><header>Assistance To improve public finance management systems</header>
<paragraph id="HA2A367BCDF3C4EBFB2DF06E959E7BC0"><enum>(1)</enum><header>In general</header><text>Consistent with the authority under section 129 of the Foreign Assistance Act of 1961 (<external-xref legal-doc="usc" parsable-cite="usc/22/2152">22 U.S.C. 2152</external-xref>), the Secretary of the Treasury, acting through the head of the Office of Technical Assistance, is authorized to provide assistance for advisors and partner country finance, health, and other relevant ministries to improve the effectiveness of public finance management systems in partner countries to enable such countries to receive funding to carry out programs to combat HIV/AIDS, tuberculosis, and malaria and to manage such programs.</text></paragraph>
<paragraph id="H879ED42E10864967BC138B0067EB4E32"><enum>(2)</enum><header>Authorization of appropriations</header><text>Of the amounts authorized to be appropriated under section 401 for HIV/AIDS assistance, there are authorized to be appropriated to the Secretary of the Treasury such sums as may be necessary for each of the fiscal years 2009 through 2013 to carry out this subsection.</text></paragraph></subsection>
<subsection id="H8F872F7DE2004C2F8148C293540090BE"><enum>(c)</enum><header>Plan required</header><text>The Global AIDS Coordinator, in collaboration with the Administrator of the United States Agency for International Development (USAID), shall develop and implement a plan to combat HIV/AIDS by strengthening health policies and health systems of partner countries as part of USAID’s <quote>Health Systems 2020</quote> project. Recognizing that human and institutional capacity form the core of any health care system that can sustain the fight against HIV/AIDS, tuberculosis, and malaria, the plan shall include a strategy to encourage postsecondary educational institutions in partner countries, particularly in Africa, in collaboration with United States postsecondary educational institutions, including historically black colleges and universities, to develop such human and institutional capacity and in the process further build their capacity to sustain the fight against these diseases.</text></subsection></section><after-quoted-block>.</after-quoted-block></quoted-block></subsection>
<subsection id="HDF8C08685F824285895C9400D493BEE6"><enum>(b)</enum><header>Clerical amendment</header><text>The table of contents for the <short-title>United States Leadership Against HIV/AIDS, Tuberculosis, and Malaria Act of 2003</short-title> (<external-xref legal-doc="usc" parsable-cite="usc/22/7601">22 U.S.C. 7601</external-xref> note) is amended by inserting after the item relating to section 203, as added by section 203 of this Act, the following:</text>
<quoted-block id="HFA5C11F0904B4BC993913200C954949E" style="OLC">
<toc>
<toc-entry level="section">Sec. 204. Combating HIV/AIDS, tuberculosis, and malaria by strengthening health policies and health systems of partner countries.</toc-entry></toc><after-quoted-block>.</after-quoted-block></quoted-block></subsection></section>
<section id="H3E28F45D313C4A64ACA509E950D1FF49"><enum>205.</enum><header>Facilitating effective operations of the Centers for Disease Control</header><text display-inline="no-display-inline">Section 307 of the Public Health Service Act (<external-xref legal-doc="usc" parsable-cite="usc/42/242l">42 U.S.C. 242l</external-xref>) is amended—</text>
<paragraph id="HE4586DD3ED504FFF9B0026A949807400"><enum>(1)</enum><text>by amending subsection (a) to read as follows:</text>
<quoted-block display-inline="no-display-inline" id="HF8A2F4C3A261422C9C94EB665F506C74" style="OLC">
<subsection id="H3C671F9ADE8B4AE3AE752B065306E92E"><enum>(a)</enum><text>The Secretary may participate with other countries in cooperative endeavors in—</text>
<paragraph id="HA3A6B06140E74B9C84C45594A6A23F5D"><enum>(1)</enum><text>biomedical research, health care technology, and the health services research and statistical analysis authorized under section 306 and title IX; and</text></paragraph>
<paragraph id="H48B83FAA9FB545DBA9339307C3A4AF68"><enum>(2)</enum><text>biomedical research, health care services, health care research, or other related activities in furtherance of the activities, objectives or goals authorized under the <short-title>Tom Lantos and Henry J. Hyde United States Global Leadership Against HIV/AIDS, Tuberculosis, and Malaria Reauthorization Act of 2008</short-title>.</text></paragraph></subsection><after-quoted-block>; and</after-quoted-block></quoted-block></paragraph>
<paragraph id="H7136D1A52BEF4EFA8C862E60DFF6D7A6"><enum>(2)</enum><text>in subsection (b)—</text>
<subparagraph id="H3826FD1123F546B590EACC1835DB9537"><enum>(A)</enum><text>in paragraph (7), by striking <quote>and</quote> after the semicolon at the end;</text></subparagraph>
<subparagraph id="HD90420B5A40340A19D87AAFABC95A397"><enum>(B)</enum><text>by striking <quote>The Secretary may not, in the exercise of his authority under this section, provide financial assistance for the construction of any facility in any foreign country.</quote></text></subparagraph>
<subparagraph id="H76852DBA50FD4DFB00F7D400D8CE28F"><enum>(C)</enum><text>in paragraph (8), by striking <quote>for any purpose.</quote> and inserting <quote>for the purpose of any law administered by the Office of Personnel Management;</quote>; and</text></subparagraph>
<subparagraph id="H9905509950CF482AA238C25D22396B14"><enum>(D)</enum><text>by adding at the end the following:</text>
<quoted-block display-inline="no-display-inline" id="HDFAC454BD9B0406A9EACF8B2FD17F64E" style="OLC">
<paragraph id="HDC54A753AA284A56889400EA2983BE57"><enum>(9)</enum><text>provide such funds by advance or reimbursement to the Secretary of State, as may be necessary, to pay the costs of acquisition, lease, construction, alteration, equipping, furnishing or management of facilities outside of the United States; and</text></paragraph>
<paragraph id="H81930C765215418AACCC61098DCB1117"><enum>(10)</enum><text>in consultation with the Secretary of State, through grant or cooperative agreement, make funds available to public or nonprofit private institutions or agencies in foreign countries in which the Secretary is participating in activities described under subsection (a) to acquire, lease, construct, alter, or renovate facilities in those countries.</text></paragraph><after-quoted-block>.</after-quoted-block></quoted-block></subparagraph></paragraph>
<paragraph id="H0631F4B29DC34CE4A056B01DCB6700CA"><enum>(3)</enum><text>in subsection (c)—</text>
<subparagraph id="HC5826A0B622D4B99B8074799BD593161"><enum>(A)</enum><text>by striking <quote>1990</quote> and inserting <quote>1980</quote>; and</text></subparagraph>
<subparagraph id="HC946AB510173468893DD6DFC73C7B849"><enum>(B)</enum><text>by inserting or <quote>or section 903 of the Foreign Service Act of 1980 (<external-xref legal-doc="usc" parsable-cite="usc/22/4083">22 U.S.C. 4083</external-xref>)</quote> after <quote>Code</quote>.</text></subparagraph></paragraph></section>
<section id="HB3B7AAB57269460A9120392EE494F34C"><enum>206.</enum><header>Facilitating vaccine development</header>
<subsection id="HD28AB745E15D4DB0A6C5D381B84326E3"><enum>(a)</enum><header>Technical assistance for developing countries</header><text>The Administrator of the United States Agency for International Development, utilizing public-private partners, as appropriate, and working in coordination with other international development agencies, is authorized to strengthen the capacity of developing countries’ governmental institutions to—</text>
<paragraph id="H8CCF5AA993D64364A7A4C55BE11216D8"><enum>(1)</enum><text>collect evidence for informed decision-making and introduction of new vaccines, including potential HIV/AIDS, tuberculosis, and malaria vaccines, if such vaccines are determined to be safe and effective;</text></paragraph>
<paragraph id="HAC638C4FD3E243528D15CC27AD00A27F"><enum>(2)</enum><text>review protocols for clinical trials and impact studies and improve the implementation of clinical trials; and</text></paragraph>
<paragraph id="H7E99B92401134C10825B1967E53F7B8F"><enum>(3)</enum><text>ensure adequate supply chain and delivery systems.</text></paragraph></subsection>
<subsection id="H80FBD83367D949A6B9249562BFBF64B3"><enum>(b)</enum><header>Advanced market commitments</header>
<paragraph id="H37F4BBEED0C6409691ABD35785283169"><enum>(1)</enum><header>Purpose</header><text>The purpose of this subsection is to improve global health by requiring the United States to participate in negotiations for advance market commitments for the development of future vaccines, including potential vaccines for HIV/AIDS, tuberculosis, and malaria.</text></paragraph>
<paragraph id="H485CEC7BC6794C04A853D08B99563D3D"><enum>(2)</enum><header>Negotiation requirement</header><text>The Secretary of the Treasury shall enter into negotiations with the appropriate officials of the International Bank of Reconstruction and Development (World Bank) and the GAVI Alliance, the member nations of such entities, and other interested parties to establish advanced market commitments to purchase vaccines to combat HIV/AIDS, tuberculosis, malaria, and other related infectious diseases.</text></paragraph>
<paragraph id="HB9D016B61C9B4A0BBD2CDD6F72700089"><enum>(3)</enum><header>Requirements</header><text>In negotiating the United States participation in programs for advanced market commitments, the Secretary of the Treasury shall take into account whether programs for advance market commitments include—</text>
<subparagraph id="H8D1506AE2F20446DA4E185589D8609E1"><enum>(A)</enum><text>legally binding contracts for product purchase that include a fair market price for up to a maximum number of treatments, creating a strong market incentive;</text></subparagraph>
<subparagraph id="H3ECCE8D3E34640B0B92BF9FF8715B497"><enum>(B)</enum><text>clearly defined and transparent rules of program participation for qualified developers and suppliers of the product;</text></subparagraph>
<subparagraph id="HA19F845FF2344945AA7B6C79675478D"><enum>(C)</enum><text>clearly defined requirements for eligible vaccines to ensure that they are safe and effective and can be delivered in developing country contexts;</text></subparagraph>
<subparagraph id="HE1CDC5F252E14D5BBE37DC0028EFBA83"><enum>(D)</enum><text>dispute settlement mechanisms; and</text></subparagraph>
<subparagraph id="HEE5664B8CA9542368CC779576E4C26FC"><enum>(E)</enum><text>sufficient flexibility to enable the contracts to be adjusted in accord with new information related to projected market size and other factors while still maintaining the purchase commitment at a fair price.</text></subparagraph></paragraph>
<paragraph id="H2A89590A1A4A40C79C0128AE58E7F85B"><enum>(4)</enum><header>Report</header><text>Not later than 1 year after the date of the enactment of this Act—</text>
<subparagraph id="HEC0EA20026384156A86E33C9D0A7ED84"><enum>(A)</enum><text>the Secretary of the Treasury shall submit a report to the appropriate congressional committees on the status of the United States negotiations to participate in programs for the advanced market commitments under this subsection; and</text></subparagraph>
<subparagraph id="HD28912E41A6946B5AE4B26EC5E7B507F"><enum>(B)</enum><text>the President shall produce a comprehensive report, written by a study group of qualified professionals from relevant Federal agencies and initiatives, nongovernmental organizations, and industry representatives, that sets forth a coordinated strategy to accelerate development of vaccines for infectious diseases, such as HIV/AIDS, malaria, and tuberculosis, which includes—</text>
<clause id="HE5277D9022534B39BE78761C21B3B4C9"><enum>(i)</enum><text>initiatives to create economic incentives for the research, development, and manufacturing of vaccines for HIV/AIDS, tuberculosis, malaria, and other infectious diseases;</text></clause>
<clause id="H8B04126FCFED498EBCD0263659FE062D"><enum>(ii)</enum><text>an expansion of public-private partnerships and the leveraging of resources from other countries and the private sector; and</text></clause>
<clause id="HACEC78893F5B4DD7AA069CEE787501CC"><enum>(iii)</enum><text>efforts to maximize United States capabilities to support clinical trials of vaccines in developing countries and to address the challenges of delivering vaccines in developing countries to minimize delays in access once vaccines are available.</text></clause></subparagraph></paragraph></subsection></section>
<enum>III</enum><header>Bilateral Efforts</header>
<subtitle id="H3920D0B70F014699903B394E90E11758"><enum>A</enum><header>General Assistance and Programs</header>
<section id="H6A64AA33803A4BBBA4FF2DD38466E3C3"><enum>301.</enum><header>Assistance to combat HIV/AIDS</header>
<subsection id="H0279FE632E114343842B6650E06BFC1D"><enum>(a)</enum><header>Amendments to the Foreign Assistance Act of 1961</header>
<paragraph id="HEDB91E10E1FC48F5B568C0866C5645E6"><enum>(1)</enum><header>Finding</header><text>Section 104A(a) of the Foreign Assistance Act of 1961 (<external-xref legal-doc="usc" parsable-cite="usc/22/2151b-2">22 U.S.C. 2151b–2(a)</external-xref>) is amended by inserting <quote>Central Asia, Eastern Europe, Latin America</quote> after <quote>Caribbean,</quote>.</text></paragraph>
<paragraph id="H0438C0FF6F244FF5A5CC21DFB5DDB76"><enum>(2)</enum><header>Policy</header><text>Section 104A(b) of such Act is amended to read as follows:</text>
<quoted-block display-inline="no-display-inline" id="H879B5622A25440B79C8E969F7C7B1207" style="OLC">
<subsection id="HED3D5E3775924B3EBE532DB699F294DB"><enum>(b)</enum><header>Policy</header>
<paragraph id="H62C84826A1C447FF9E3C6B445E9FEE48"><enum>(1)</enum><header>Objectives</header><text>It is a major objective of the foreign assistance program of the United States to provide assistance for the prevention and treatment of HIV/AIDS and the care of those affected by the disease. It is the policy objective of the United States, by 2013, to—</text>
<subparagraph id="H2E6083D75BC040DE8536676C68EB2F00"><enum>(A)</enum><text>assist partner countries to—</text>
<clause id="HA3221EC2E1E64464BEE5C4CB28A6132F"><enum>(i)</enum><text>prevent 12,000,000 new HIV infections worldwide;</text></clause>
<clause id="H14AE087EA08C4C64A5094248B211072E"><enum>(ii)</enum><text>support—</text>
<subclause id="H6897833108264131B366EFAB5C51EF6F"><enum>(I)</enum><text>the increase in the number of individuals with HIV/AIDS receiving antiretroviral treatment above the goal established under section 402(a)(3) and increased pursuant to paragraphs (1) through (3) of section 403(d); and</text></subclause>
<subclause id="H9A54E0C43E5D4A25AEF1A508E601BE38"><enum>(II)</enum><text>additional treatment through coordinated multilateral efforts;</text></subclause></clause>
<clause id="HB695C5C8A67D426699FB5E9B9079995D"><enum>(iii)</enum><text>support care for 12,000,000 individuals infected with or affected by HIV/AIDS, including 5,000,000 orphans and vulnerable children affected by HIV/AIDS, with an emphasis on promoting a comprehensive, coordinated system of services to be integrated throughout the continuum of care;</text></clause>
<clause id="H55A55C9889C54C9B96E0326F8702C9E"><enum>(iv)</enum><text>provide at least 80 percent of the target population with access to counseling, testing, and treatment to prevent the transmission of HIV from mother-to-child;</text></clause>
<clause id="H40361249FB894CD9A1934E00ACD83CB1"><enum>(v)</enum><text>provide care and treatment services to children with HIV in proportion to their percentage within the HIV-infected population of a given partner country; and</text></clause>
<clause id="H31AFBBFA02344256A6426E67A7F61D15"><enum>(vi)</enum><text>train and support retention of health care professionals, paraprofessionals, and community health workers in HIV/AIDS prevention, treatment, and care, with the target of providing such training to at least 140,000 new health care professionals and paraprofessionals with an emphasis on training and in country deployment of critically needed doctors and nurses;</text></clause></subparagraph>
<subparagraph id="H79793F8C30204DE09EE3E3852BCAAC7"><enum>(B)</enum><text>strengthen the capacity to deliver primary health care in developing countries, especially in sub-Saharan Africa;</text></subparagraph>
<subparagraph id="HC39334E915384454B05D4364D7078955"><enum>(C)</enum><text>support and help countries in their efforts to achieve staffing levels of at least 2.3 doctors, nurses, and midwives per 1,000 population, as called for by the World Health Organization; and</text></subparagraph>
<subparagraph id="H032D7033778A43028DB20078622BF9FB"><enum>(D)</enum><text>help partner countries to develop independent, sustainable HIV/AIDS programs.</text></subparagraph></paragraph>
<paragraph id="H7A310E3DC9DE41018111E29B1FE938F3"><enum>(2)</enum><header>Coordinated global strategy</header><text>The United States and other countries with the sufficient capacity should provide assistance to countries in sub-Saharan Africa, the Caribbean, Central Asia, Eastern Europe, and Latin America, and other countries and regions confronting HIV/AIDS epidemics in a coordinated global strategy to help address generalized and concentrated epidemics through HIV/AIDS prevention, treatment, care, monitoring and evaluation, and related activities.</text></paragraph>
<paragraph id="H9B6A2A9E9FC647ECA600A2849BA16E82"><enum>(3)</enum><header>Priorities</header><text>The United States Government’s response to the global HIV/AIDS pandemic and the Government’s efforts to help countries assume leadership of sustainable campaigns to combat their local epidemics should place high priority on—</text>
<subparagraph id="HD6C11A5465A64D868DB344C7C3DFC4"><enum>(A)</enum><text>the prevention of the transmission of HIV;</text></subparagraph>
<subparagraph id="H04E3534120794A9BACA51BFFC63771C9"><enum>(B)</enum><text>moving toward universal access to HIV/AIDS prevention counseling and services;</text></subparagraph>
<subparagraph id="H8D2F03CBB24E481FAADBC95C53E25B00"><enum>(C)</enum><text>the inclusion of cost sharing assurances that meet the requirements under section 110; and</text></subparagraph>
<subparagraph id="HC0C949D7ABB64A399CF128D4BF384E91"><enum>(D)</enum><text>the inclusion of transition strategies to ensure sustainability of such programs and activities, including health care systems, under other international donor support, or budget support by respective foreign governments.</text></subparagraph></paragraph></subsection><after-quoted-block>.</after-quoted-block></quoted-block></paragraph></subsection>
<subsection id="H445521468B2941A9A25245175BA63F8D"><enum>(b)</enum><header>Authorization</header><text>Section 104A(c) of such Act is amended—</text>
<paragraph id="H3194CA4F0BC842D980D3EE35C7B70056"><enum>(1)</enum><text>in paragraph (1), by striking <quote>and other countries and areas.</quote> and inserting <quote>Central Asia, Eastern Europe, Latin America, and other countries and areas, particularly with respect to refugee populations or those in postconflict settings in such countries and areas with significant or increasing HIV incidence rates.</quote>;</text></paragraph>
<paragraph id="H69589C0FC72149EBB532E1DE97739CD6"><enum>(2)</enum><text>in paragraph (2), by striking <quote>and other countries and areas affected by the HIV/AIDS pandemic</quote> and inserting <quote>Central Asia, Eastern Europe, Latin America, and other countries and areas affected by the HIV/AIDS pandemic, particularly with respect to refugee populations or those in post-conflict settings in such countries and areas with significant or increasing HIV incidence rates.</quote>; and</text></paragraph>
<paragraph id="H76BD830EA49D4104B1872E3EEE617830"><enum>(3)</enum><text>in paragraph (3)—</text>
<subparagraph id="H84A0316981974519A8B241C242A628FF"><enum>(A)</enum><text>by striking <quote>foreign countries</quote> and inserting <quote>partner countries, other international actors,</quote>; and</text></subparagraph>
<subparagraph id="H8983BF8989364D7000701ECB8E1557A7"><enum>(B)</enum><text>by inserting <quote>within the framework of the principles of the Three Ones</quote> before the period at the end.</text></subparagraph></paragraph></subsection>
<subsection id="H9ADF4E7DEAFC4FAF99BF89F2315E3D27"><enum>(c)</enum><header>Activities supported</header><text>Section 104A(d) of such Act is amended—</text>
<paragraph id="HA080A48FAF134726BBF596A4F862BF60"><enum>(1)</enum><text>in paragraph (1)—</text>
<subparagraph id="HC1F0C802BD20413D906083E670EA47C5"><enum>(A)</enum><text>in subparagraph (A)—</text>
<clause id="H52D3383738AD4184AB015ED8676D1BB"><enum>(i)</enum><text>by inserting <quote>and multiple concurrent sexual partnering,</quote> after <quote>casual sexual partnering</quote>; and</text></clause>
<clause id="H95457ED8091D4A08BC0904AEEB00058D"><enum>(ii)</enum><text>by striking <quote>condoms</quote> and inserting <quote>male and female condoms</quote>;</text></clause></subparagraph>
<subparagraph id="HF71A4BE07DE54D90891071B7DE4ED9C6"><enum>(B)</enum><text>in subparagraph (B)—</text>
<clause id="HCAD20C991AFE4E648B217B47B3C3A195"><enum>(i)</enum><text>by striking <quote>programs that</quote> and inserting <quote>programs that are designed with local input and</quote>; and</text></clause>
<clause id="HB3C32C3A748D4296994633C2FB918F"><enum>(ii)</enum><text>by striking <quote>those organizations</quote> and inserting <quote>those locally based organizations</quote>;</text></clause></subparagraph>
<subparagraph id="H7797F560E49E4608B47215DBB514FDD1"><enum>(C)</enum><text>in subparagraph (D), by inserting <quote>and promoting the use of provider-initiated or <quote>opt-out</quote> voluntary testing in accordance with World Health Organization guidelines</quote> before the semicolon at the end;</text></subparagraph>
<subparagraph id="HD9CA5EBF327C4ED3A73317AAC2B3F341"><enum>(D)</enum><text>by redesignating subparagraphs (F), (G), and (H) as subparagraphs (H), (I), and (J), respectively;</text></subparagraph>
<subparagraph id="HE87F0777311047A1AEEF76D77D7D855F"><enum>(E)</enum><text>by inserting after subparagraph (E) the following:</text>
<quoted-block display-inline="no-display-inline" id="HC1A139CEF6BF41A5B19737C31ED3AE53" style="OLC">
<subparagraph id="H42DB8BB185074C8FBB7640C84FDBDD8"><enum>(F)</enum><text>assistance to—</text>
<clause id="HCBE927211C8B42F19800725BB1F0E547"><enum>(i)</enum><text>achieve the goal of reaching 80 percent of pregnant women for prevention and treatment of mother-to-child transmission of HIV in countries in which the United States is implementing HIV/AIDS programs by 2013; and</text></clause>
<clause id="H2883442D11E14E6AA032F459ECCE1F72"><enum>(ii)</enum><text>promote infant feeding options and treatment protocols that meet the most recent criteria established by the World Health Organization;</text></clause></subparagraph>
<subparagraph id="H075764014F2F45D6B381F25C60313F7F"><enum>(G)</enum><text>medical male circumcision programs as part of national strategies to combat the transmission of HIV/AIDS;</text></subparagraph><after-quoted-block>;</after-quoted-block></quoted-block></subparagraph>
<subparagraph id="H1F57EF55E7344AEBB06179153BAEEC6"><enum>(F)</enum><text>in subparagraph (I), as redesignated, by striking <quote>and</quote> at the end; and</text></subparagraph>
<subparagraph id="HCF65CA6DFEC443E0AFED96F1EC5F4DF0"><enum>(G)</enum><text>by adding at the end the following:</text>
<quoted-block display-inline="no-display-inline" id="H8693694B2A904592BF881D320135397E" style="OLC">
<subparagraph id="H96D530DAE85A4657BC43F9FE03673046"><enum>(K)</enum><text>assistance for counseling, testing, treatment, care, and support programs, including—</text>
<clause id="HA4A85AFF4C6E42A48157FBDBAED80488"><enum>(i)</enum><text>counseling and other services for the prevention of reinfection of individuals with HIV/AIDS;</text></clause>
<clause id="H2417CC0E8D5640A09718F115D902DF1C"><enum>(ii)</enum><text>counseling to prevent sexual transmission of HIV, including—</text>
<subclause id="H485F50E060B84922BC3BE2C53E0130E4"><enum>(I)</enum><text>life skills development for practicing abstinence and faithfulness;</text></subclause>
<subclause id="H514619499E9641BB81557C29DC1B3C7F"><enum>(II)</enum><text>reducing the number of sexual partners;</text></subclause>
<subclause id="H9138AC4314C34C1EB1705115C2B281F4"><enum>(III)</enum><text>delaying sexual debut; and</text></subclause>
<subclause id="HBB8A342975B34E5BABA5DB7FBB25739C"><enum>(IV)</enum><text>ensuring correct and consistent use of condoms;</text></subclause></clause>
<clause id="H31BD9E4A524D4773AC23BE21C96E7B5"><enum>(iii)</enum><text>assistance to engage underlying vulnerabilities to HIV/AIDS, especially those of women and girls;</text></clause>
<clause id="H1EE0D338F0B4468F833405BDE95E964D"><enum>(iv)</enum><text>assistance for appropriate HIV/AIDS education programs and training targeted to prevent the transmission of HIV among men who have sex with men;</text></clause>
<clause id="H159BE224913A4B80B5CD00CBD23200F9"><enum>(v)</enum><text>assistance to provide male and female condoms;</text></clause>
<clause id="HF19DFC39FB7F4AC49B8552B55E007F45"><enum>(vi)</enum><text>diagnosis and treatment of other sexually transmitted infections;</text></clause>
<clause id="H627E775798EB4D36938448C60000EF3C"><enum>(vii)</enum><text>strategies to address the stigma and discrimination that impede HIV/AIDS prevention efforts; and</text></clause>
<clause id="H9704F917BC59490591363B7531008D18"><enum>(viii)</enum><text>assistance to facilitate widespread access to microbicides for HIV prevention, if safe and effective products become available, including financial and technical support for culturally appropriate introductory programs, procurement, distribution, logistics management, program delivery, acceptability studies, provider training, demand generation, and postintroduction monitoring.</text></clause></subparagraph><after-quoted-block>; and</after-quoted-block></quoted-block></subparagraph></paragraph>
<paragraph id="H836E3F4DDB9D4C2689CC8CEC9DC1C011"><enum>(2)</enum><text>in paragraph (2)—</text>
<subparagraph id="H8700525FDBC948AE82DF3B80E18E13B1"><enum>(A)</enum><text>in subparagraph (B), by striking <quote>and</quote> at the end;</text></subparagraph>
<subparagraph id="HEE579F88909A4910926224BF4E9EB382"><enum>(B)</enum><text>in subparagraph (C)—</text>
<clause id="H2B6CA13926D14CBEA40054C7E5C6E3BF"><enum>(i)</enum><text>by inserting <quote>pain management,</quote> after <quote>opportunistic infections,</quote>; and</text></clause>
<clause id="HD6EE0A902FDE462DAC56F6003C87A3D0"><enum>(ii)</enum><text>by striking the period at the end and inserting a semicolon; and</text></clause></subparagraph>
<subparagraph id="HC72D3D7075854E66AEEF459FBC3EB8D4"><enum>(C)</enum><text>by adding at the end the following:</text>
<quoted-block display-inline="no-display-inline" id="HE13EEF947A584C98814CE6B1A0AFF3D" style="OLC">
<subparagraph id="HC36F67E38FFF4213B325AA85B091C10"><enum>(D)</enum><text>as part of care and treatment of HIV/AIDS, assistance (including prophylaxis and treatment) for common HIV/AIDS-related opportunistic infections for free or at a rate at which it is easily affordable to the individuals and populations being served;</text></subparagraph>
<subparagraph id="H23DDD5FDD686420FADB4FBBA401C6521"><enum>(E)</enum><text>as part of care and treatment of HIV/AIDS, assistance or referral to available and adequately resourced service providers for nutritional support, including counseling and where necessary the provision of commodities, for persons meeting malnourishment criteria and their families;</text></subparagraph><after-quoted-block>;</after-quoted-block></quoted-block></subparagraph></paragraph>
<paragraph id="H65AE18F78CC74A60B5BB2C24CA7C3F5"><enum>(3)</enum><text>in paragraph (4)—</text>
<subparagraph id="H6C28F83E5B464A119692CFB2E9F4B196"><enum>(A)</enum><text>in subparagraph (C), by striking <quote>and</quote> at the end;</text></subparagraph>
<subparagraph id="HAEAA3A8F53604D3B8EC142B899E6A0C6"><enum>(B)</enum><text>in subparagraph (D), by striking the period at the end and inserting a semicolon; and</text></subparagraph>
<subparagraph id="H858E81B1F0CE4BBB8D51657546C34954"><enum>(C)</enum><text>by adding at the end the following:</text>
<quoted-block display-inline="no-display-inline" id="H873EC82BB211490DAEDD7B2F8468FD65" style="OLC">
<subparagraph id="HEBA252BAF418492F95F95565E66FC94"><enum>(E)</enum><text>carrying out and expanding program monitoring, impact evaluation research and analysis, and operations research and disseminating data and findings through mechanisms to be developed by the Coordinator of United States Government Activities to Combat HIV/AIDS Globally, in coordination with the Director of the Centers for Disease Control, in order to—</text>
<clause id="H89CA7E899F1347439E0821AAFC6C7B9B"><enum>(i)</enum><text>improve accountability, increase transparency, and ensure the delivery of evidence-based services through the collection, evaluation, and analysis of data regarding gender-responsive interventions, disaggregated by age and sex;</text></clause>
<clause id="HECDAC7075C994B6A8BC7989470498FA2"><enum>(ii)</enum><text>identify and replicate effective models; and</text></clause>
<clause id="H0766EF1D533C470B94CBB34B58A934C6"><enum>(iii)</enum><text>develop gender indicators to measure outcomes and the impacts of interventions; and</text></clause></subparagraph>
<subparagraph id="H907876E633934F26928F9D6383C192E"><enum>(F)</enum><text>establishing appropriate systems to—</text>
<clause id="HFD3F16536E1947909F46C56B52D9C49D"><enum>(i)</enum><text>gather epidemiological and social science data on HIV; and</text></clause>
<clause id="HC7051984230D4246A7803F403932D46"><enum>(ii)</enum><text>evaluate the effectiveness of prevention efforts among men who have sex with men, with due consideration to stigma and risks associated with disclosure.</text></clause></subparagraph><after-quoted-block>;</after-quoted-block></quoted-block></subparagraph></paragraph>
<paragraph id="H3F8D94AA554B4E9089F42930116BC7D"><enum>(4)</enum><text>in paragraph (5)—</text>
<subparagraph id="HDB03DC7E7D924404AF2FFF894F1E7B7C"><enum>(A)</enum><text>by redesignating subparagraph (C) as subparagraph (D); and</text></subparagraph>
<subparagraph id="H7E3BC7BE6C7A4C3CBFB2BCF4BBFD41D"><enum>(B)</enum><text>by inserting after subparagraph (B) the following:</text>
<quoted-block display-inline="no-display-inline" id="H71E0924A93CA458FAA854E7B8594751C" style="OLC">
<subparagraph id="HA941C686FB484311BCDA602E9F4255B7"><enum>(C)</enum><header>Mechanism to ensure cost-effective drug purchasing</header><text>Subject to subparagraph (B), mechanisms to ensure that safe and effective pharmaceuticals, including antiretrovirals and medicines to treat opportunistic infections, are purchased at the lowest possible price at which such pharmaceuticals may be obtained in sufficient quantity on the world market, provided that such pharmaceuticals are approved, tentatively approved, or otherwise authorized for use by—</text>
<clause id="H41B76BBA53C04F94859CECC5B70C34E"><enum>(i)</enum><text>the Food and Drug Administration;</text></clause>
<clause id="H9B3D70C7DDCC40C082FBF5600C91842"><enum>(ii)</enum><text>a stringent regulatory agency acceptable to the Secretary of Health and Human Services; or</text></clause>
<clause id="H791C0315B5A4484D00272C67FB4D4F1D"><enum>(iii)</enum><text>a quality assurance mechanism acceptable to the Secretary of Health and Human Services.</text></clause></subparagraph><after-quoted-block>;</after-quoted-block></quoted-block></subparagraph></paragraph>
<paragraph id="H554EC18FA7354591A27D70226EF62C13"><enum>(5)</enum><text>in paragraph (6)—</text>
<subparagraph id="H7C810540693E432BAFD46743FBB6AEA"><enum>(A)</enum><text>by amending the paragraph heading to read as follows:</text>
<quoted-block display-inline="no-display-inline" id="H490D534AD61A4D53893BCFFAF9569DFD" style="OLC">
<paragraph id="HCFFBD02A171A4987B77116B5165800BA"><enum>(6)</enum><header>Related and coordinated activities</header></paragraph><after-quoted-block>;</after-quoted-block></quoted-block></subparagraph>
<subparagraph id="H5B8A387F81054FD1A2EB025E1DABEBAC"><enum>(B)</enum><text>in subparagraph (B), by striking <quote>and</quote> at the end;</text></subparagraph>
<subparagraph id="H3525E4B2FFCE4582B79FE2C4A043126B"><enum>(C)</enum><text>in subparagraph (C), by striking the period at the end and inserting <quote>; and</quote>; and</text></subparagraph>
<subparagraph id="H07CBB492C10245BC9EAB47AB86F17690"><enum>(D)</enum><text>by adding at the end the following:</text>
<quoted-block display-inline="no-display-inline" id="HB5AC84414A2E49AF009C4DB66F8D8946" style="OLC">
<subparagraph id="HFC3DB42CBD104603A3EC5DC3BEEEBED7"><enum>(D)</enum><text>coordinated or referred activities to—</text>
<clause id="HAE0B19AB48624517B98649B2D9D935FC"><enum>(i)</enum><text>enhance the clinical impact of HIV/AIDS care and treatment; and</text></clause>
<clause id="H6D01AE88EF074375B2FACF00ABEFFF9E"><enum>(ii)</enum><text>ameliorate the adverse social and economic costs often affecting AIDS-impacted families and communities through the direct provision, as necessary, or through the referral, if possible, of support services, including—</text>
<subclause id="HFF322CBC5511420B8CBB4E436885B4F8"><enum>(I)</enum><text>nutritional and food support;</text></subclause>
<subclause id="HCA29B3537D8048C1B21CC64768B7B522"><enum>(II)</enum><text>safe drinking water and adequate sanitation;</text></subclause>
<subclause id="H9CAE59FB36D94F3A837B670521C08C33"><enum>(III)</enum><text>nutritional counseling;</text></subclause>
<subclause id="HBAEC87FF811942E5B7A4E5AE6808448E"><enum>(IV)</enum><text>income-generating activities and livelihood initiatives;</text></subclause>
<subclause id="H99E4AB6DD94345218286999E8FEDB061"><enum>(V)</enum><text>maternal and child health care;</text></subclause>
<subclause id="H23849EF86A9C48269E659E3F179EAF20"><enum>(VI)</enum><text>primary health care;</text></subclause>
<subclause id="HD1BEA5D10C4F4A1D8657B9A86D5B797C"><enum>(VII)</enum><text>the diagnosis and treatment of other infectious or sexually transmitted diseases;</text></subclause>
<subclause id="H52914D0A016446619899DF2F844FF7C0"><enum>(VIII)</enum><text>substance abuse and treatment services; and</text></subclause>
<subclause id="H5F0952D398964542996EF9B2500032AF"><enum>(IX)</enum><text>legal services;</text></subclause></clause></subparagraph>
<subparagraph id="H6141718DC46646A492C06C597F00E797"><enum>(E)</enum><text>coordinated or referred activities to link programs addressing HIV/AIDS with programs addressing gender-based violence in areas of significant HIV prevalence to assist countries in the development and enforcement of women’s health, children’s health, and HIV/AIDS laws and policies that—</text>
<clause id="H98FEAF53E18A45DC88D9577E519B14B"><enum>(i)</enum><text>prevent and respond to violence against women and girls;</text></clause>
<clause id="HE55CF51F4C5F499D9F205B835D84B900"><enum>(ii)</enum><text>promote the integration of screening and assessment for gender-based violence into HIV/AIDS programming;</text></clause>
<clause id="H30F74DC484834DFEB36D805090E98DE0"><enum>(iii)</enum><text>promote appropriate HIV/AIDS counseling, testing, and treatment into gender-based violence programs; and</text></clause>
<clause id="HA819A8B7DDBF4B058BFEDBFEF96D5A5"><enum>(iv)</enum><text>assist governments to develop partnerships with civil society organizations to create networks for psychosocial, legal, economic, or other support services;</text></clause></subparagraph>
<subparagraph id="HE6AAA352A51F44ACA9FCACBB1ED99100"><enum>(F)</enum><text>coordinated or referred activities to—</text>
<clause id="H32649139E39F4CF68E0735F37C9FC46"><enum>(i)</enum><text>address the frequent coinfection of HIV and tuberculosis, in accordance with World Health Organization guidelines;</text></clause>
<clause id="HFBEF78407EB541258EF5054608A8D3CA"><enum>(ii)</enum><text>promote provider-initiated or <quote>opt-out</quote> HIV/AIDS counseling and testing and appropriate referral for treatment and care to individuals with tuberculosis or its symptoms, particularly in areas with significant HIV prevalence; and</text></clause>
<clause id="H0A140D9A4560400BB26EBFD462D29C64"><enum>(iii)</enum><text>strengthen programs to ensure that individuals testing positive for HIV receive tuberculosis screening and to improve laboratory capacities, infection control, and adherence; and</text></clause></subparagraph>
<subparagraph id="HA31AE0D224DE483691565D2092081DBD"><enum>(G)</enum><text>activities to—</text>
<clause id="H7A83EA8BBBEF43D2B1EBED98E3DE7008"><enum>(i)</enum><text>improve the effectiveness of national responses to HIV/AIDS;</text></clause>
<clause id="HC280D40D79324E13AC6E4304083F1143"><enum>(ii)</enum><text>strengthen overall health systems in high-prevalence countries, including support for workforce training, retention, and effective deployment, capacity building, laboratory development, equipment maintenance and repair, and public health and related public financial management systems and operations; and</text></clause>
<clause id="HD4649C3EEE484795A529D9056972F356"><enum>(iii)</enum><text>encourage fair and transparent procurement practices among partner countries; and</text></clause>
<clause commented="no" display-inline="no-display-inline" id="HD71F62D7E5834B3B9E82EC8E8D950002"><enum>(iv)</enum><text display-inline="yes-display-inline">promote in-country or intra-regional pediatric training for physicians and other health professionals, preferably through public-private partnerships involving colleges and universities, with the goal of increasing pediatric HIV workforce capacity.</text></clause></subparagraph><after-quoted-block>; and</after-quoted-block></quoted-block></subparagraph></paragraph>
<paragraph id="HA361FF41CAC6418E8494D215B58B44A7"><enum>(6)</enum><text>by adding at the end the following:</text>
<quoted-block display-inline="no-display-inline" id="H34992042AE964BC592A1DEC0F0C78963" style="OLC">
<paragraph id="HC55C3A6FC5504527A989B2ECFE5CE2C2"><enum>(8)</enum><header>Compacts and framework agreements</header><text>The development of compacts or framework agreements, tailored to local circumstances, with national governments or regional partnerships in countries with significant HIV/AIDS burdens to promote host government commitment to deeper integration of HIV/AIDS services into health systems, contribute to health systems overall, and enhance sustainability, including—</text>
<subparagraph id="HAD294912B2FF47490016F4AC002FF2DF"><enum>(A)</enum><text>cost sharing assurances that meet the requirements under section 110; and</text></subparagraph>
<subparagraph id="HD02D3F03234E4811AD64989BEBF7B607"><enum>(B)</enum><text>transition strategies to ensure sustainability of such programs and activities, including health care systems, under other international donor support, or budget support by respective foreign governments.</text></subparagraph></paragraph><after-quoted-block>.</after-quoted-block></quoted-block></paragraph></subsection>
<subsection id="H760098B6D6E549D99E444FF519194317"><enum>(d)</enum><header>Compacts and framework agreements</header><text>Section 104A of such Act is amended—</text>
<paragraph id="H628C2ED0BB2741E98700C1FCFC9FB902"><enum>(1)</enum><text>by redesignating subsections (e) through (g) as subsections (f) through (h); and</text></paragraph>
<paragraph id="H227C2CA4EA9148F69D5ECCA5EA6D845"><enum>(2)</enum><text>by inserting after subsection (d) the following:</text>
<quoted-block display-inline="no-display-inline" id="H1BDB6E56EACC46539BE44986238935EA" style="OLC">
<subsection id="H296BC10637414740B851166133C21C9F"><enum>(e)</enum><header>Compacts and framework agreements</header>
<paragraph id="H65A1094D399F46ABA6E7437644442EDF"><enum>(1)</enum><header>Findings</header><text>Congress makes the following findings:</text>
<subparagraph id="H10805677828F4999A59952D3A94E88CA"><enum>(A)</enum><text>The congressionally mandated Institute of Medicine report entitled <quote>PEPFAR Implementation: Progress and Promise</quote> states: <quote>The next strategy [of the U.S. Global AIDS Initiative] should squarely address the needs and challenges involved in supporting sustainable country HIV/AIDS programs, thereby transitioning from a focus on emergency relief.</quote>.</text></subparagraph>
<subparagraph id="H606BDEEED09C4AE183020055FFF406D0"><enum>(B)</enum><text>One mechanism to promote the transition from an emergency to a public health and development approach to HIV/AIDS is through compacts or framework agreements between the United States Government and each participating nation.</text></subparagraph></paragraph>
<paragraph id="H8F8C204ABBF8436AB3DF266495A9E815"><enum>(2)</enum><header>Elements</header><text>Compacts on HIV/AIDS authorized under subsection (d)(8) shall include the following elements:</text>
<subparagraph id="HE77536C37D2D4C36963CB74B986489A9"><enum>(A)</enum><text>Compacts whose primary purpose is to provide direct services to combat HIV/AIDS are to be made between—</text>
<clause id="H20CAE4C5A2954427B46086D4FD2E75A8"><enum>(i)</enum><text>the United States Government; and</text></clause>
<clause id="HE24DA497CED3481890580073FBD100A5"><enum>(ii)</enum>
<subclause commented="no" display-inline="yes-display-inline" id="HD1DEE8B9E7CB4BBD8B72BC7819F7D925"><enum>(I)</enum><text>national or regional entities representing low-income countries served by an existing United States Agency for International Development or Department of Health and Human Services presence or regional platform; or</text></subclause>
<subclause id="H2A9F8B5560BB4481837587C5E17BA3E" indent="up1"><enum>(II)</enum><text>countries or regions—</text>
<item id="HBDB1964D8C4948B3B7FD029F2C23F94C"><enum>(aa)</enum><text>experiencing significantly high HIV prevalence or risk of significantly increasing incidence within the general population;</text></item>
<item id="HD09BB4FEA3E245059700A7B3F057B525"><enum>(bb)</enum><text>served by an existing United States Agency for International Development or Department of Health and Human Services presence or regional platform; and</text></item>
<item id="H1065DEB37EFF424F9159004E758500E6"><enum>(cc)</enum><text>that have inadequate financial means within such country or region.</text></item></subclause></clause></subparagraph>
<subparagraph id="H4CDDE24691FA41FB9D393D30813D6643"><enum>(B)</enum><text>Compacts whose primary purpose is to provide limited technical assistance to a country or region connected to services provided within the country or region—</text>
<clause id="HA4729FC2C1324DF78C82453649501290"><enum>(i)</enum><text>may be made with other countries or regional entities served by an existing United States Agency for International Development or Department of Health and Human Services presence or regional platform;</text></clause>
<clause id="HB0EE6523CC5B4CBDA5CA2B53C93C7CD1"><enum>(ii)</enum><text>shall require significant investments in HIV prevention, care, and treatment services by the host country;</text></clause>
<clause id="H6566BE35D91A40A8A7072FD89516EB9F"><enum>(iii)</enum><text>shall be time-limited in terms of United States contributions; and</text></clause>
<clause id="HA59426A7E678427F912176CD94D4BBB"><enum>(iv)</enum><text>shall be made only upon prior notification to Congress—</text>
<subclause id="H853951C951D04FE09CC725C532B08297"><enum>(I)</enum><text>justifying the need for such compacts;</text></subclause>
<subclause id="HE948EEF167634928878206B66BEC176"><enum>(II)</enum><text>describing the expected investment by the country or regional entity; and</text></subclause>
<subclause id="H654339BA2F6845BCB5EB361603D88696"><enum>(III)</enum><text>describing the scope, nature, expected total United States investment, and time frame of the limited technical assistance under the compact and its intended impact.</text></subclause></clause></subparagraph>
<subparagraph id="H26EEAE0A30214561B7EBFFD76E8F2BE"><enum>(C)</enum><text>Compacts shall include provisions to—</text>
<clause id="H0A51BE84CDBC4454BC7F6E3D6D7D58F6"><enum>(i)</enum><text>promote local and national efforts to reduce stigma associated with HIV/AIDS; and</text></clause>
<clause id="HE2F5EF8638A440A8832C9ECE7B1954D"><enum>(ii)</enum><text>work with and promote the role of civil society in combating HIV/AIDS.</text></clause></subparagraph>
<subparagraph id="H2EDD3559E799471EAECCB913F601F392"><enum>(D)</enum><text>Compacts shall take into account the overall national health and development and national HIV/AIDS and public health strategies of each country.</text></subparagraph>
<subparagraph id="H5C5D27E890CD44D4A8AD7D5FDFBF2021"><enum>(E)</enum><text>Compacts shall contain—</text>
<clause id="HDD43C5FD03F647C2BC6BB8E26E43B664"><enum>(i)</enum><text>consideration of the specific objectives that the country and the United States expect to achieve during the term of a compact;</text></clause>
<clause id="H8F016910657D45F7BDD992C1D7B6355"><enum>(ii)</enum><text>consideration of the respective responsibilities of the country and the United States in the achievement of such objectives;</text></clause>
<clause id="H1EC9C5DD1E0646ADA89814F583A5AC50"><enum>(iii)</enum><text>consideration of regular benchmarks to measure progress toward achieving such objectives;</text></clause>
<clause id="H7B72A2AA4643423D918775E163B2C0BC"><enum>(iv)</enum><text>an identification of the intended beneficiaries, disaggregated by gender and age, and including information on orphans and vulnerable children, to the maximum extent practicable;</text></clause>
<clause id="HF757BCFD4A6C400CBB94D845EC42992F"><enum>(v)</enum><text>consideration of the methods by which the compact is intended to—</text>
<subclause id="H181A72F18C074A038B29636685A245F4"><enum>(I)</enum><text>address the factors that put women and girls at greater risk of HIV/AIDS; and</text></subclause>
<subclause id="H55F6BA45434C4EA6A2F2FD63263BEBF3"><enum>(II)</enum><text>strengthen elements such as the economic, educational, and social status of women, girls, orphans, and vulnerable children and the inheritance rights and safety of such individuals;</text></subclause></clause>
<clause id="H2456AA7F704A45DAB202C18300CCC2D1"><enum>(vi)</enum><text>consideration of the methods by which the compact will—</text>
<subclause id="HF8646CB4D6594371A07096C21DF7096"><enum>(I)</enum><text>strengthen the health care capacity, including factors such as the training, retention, deployment, recruitment, and utilization of health care workers;</text></subclause>
<subclause id="H4684BBAAE3AF4392BE1BD7C8C57F4673"><enum>(II)</enum><text>improve supply chain management; and</text></subclause>
<subclause id="HB12958DF1E6448D6BE9D172C1B23AE74"><enum>(III)</enum><text>improve the health systems and infrastructure of the partner country, including the ability of compact participants to maintain and operate equipment transferred or purchased as part of the compact;</text></subclause></clause>
<clause id="HEBB46BBC0689406581FA36C40508F1BA"><enum>(vii)</enum><text>consideration of proposed mechanisms to provide oversight;</text></clause>
<clause id="HCF53D7D965934D00B5196400ACFB0042"><enum>(viii)</enum><text>consideration of the role of civil society in the development of a compact and the achievement of its objectives;</text></clause>
<clause id="H9C08B6ACB1734588ABE705058F536052"><enum>(ix)</enum><text>a description of the current and potential participation of other donors in the achievement of such objectives, as appropriate; and</text></clause>
<clause id="H30A619D1E4BF4E108FD9A8C7D9A0AAD7"><enum>(x)</enum><text>consideration of a plan to ensure appropriate fiscal accountability for the use of assistance.</text></clause></subparagraph>
<subparagraph id="HC71A7ACEC4194927B83BDA738D871ED7"><enum>(F)</enum><text>For regional compacts, priority shall be given to countries that are included in regional funds and programs in existence as of the date of the enactment of the <short-title>Tom Lantos and Henry J. Hyde United States Global Leadership Against HIV/AIDS, Tuberculosis, and Malaria Reauthorization Act of 2008</short-title>.</text></subparagraph>
<subparagraph id="H2FD01D43C0BC45818CFF5063649E95A5"><enum>(G)</enum><text>Amounts made available for compacts described in subparagraphs (A) and (B) shall be subject to the inclusion of—</text>
<clause id="H008B27CE159F4E50AEC9610047E8EAA7"><enum>(i)</enum><text>cost sharing assurances that meet the requirements under section 110; and</text></clause>
<clause id="H9907BAC7D07947F59BBAE0C22F958DE8"><enum>(ii)</enum><text>transition strategies to ensure sustainability of such programs and activities, including health care systems, under other international donor support, and budget support by respective foreign governments.</text></clause></subparagraph></paragraph>
<paragraph id="HE8EDC105C7C149F7B61B8175894F0349"><enum>(3)</enum><header>Local input</header><text>In entering into a compact on HIV/AIDS authorized under subsection (d)(8), the Coordinator of United States Government Activities to Combat HIV/AIDS Globally shall seek to ensure that the government of a country—</text>
<subparagraph id="HD0C1629514654DC2ACD5FDB2C648A93F"><enum>(A)</enum><text>takes into account the local perspectives of the rural and urban poor, including women, in each country; and</text></subparagraph>
<subparagraph id="H9BF739E713784424998F9E3E9F952C7E"><enum>(B)</enum><text>consults with private and voluntary organizations, including faith-based organizations, the business community, and other donors in the country.</text></subparagraph></paragraph>
<paragraph id="HC8D58C20DFB04F4D8905300069044F52"><enum>(4)</enum><header>Congressional and public notification after entering into a compact</header><text>Not later than 10 days after entering into a compact authorized under subsection (d)(8), the Global AIDS Coordinator shall—</text>
<subparagraph id="H0F3589B32DA24E66BF149FAA98B36EE2"><enum>(A)</enum><text>submit a report containing a detailed summary of the compact and a copy of the text of the compact to—</text>
<clause id="HBF9A512A17B84147A17532F0966FCE8B"><enum>(i)</enum><text>the <committee-name committee-id="">Committee on Foreign Relations of the Senate</committee-name>;</text></clause>
<clause id="HD84378AF50604A94BFB262F000862FCD"><enum>(ii)</enum><text>the <committee-name committee-id="">Committee on Appropriations of the Senate</committee-name>;</text></clause>
<clause id="H4B66CC2D1086448CBE0368C8FD383C27"><enum>(iii)</enum><text>the <committee-name committee-id="">Committee on Foreign Affairs of the House of Representatives</committee-name>; and</text></clause>
<clause id="HDC8623B340084E30BE5379C3A3A22258"><enum>(iv)</enum><text>the <committee-name committee-id="">Committee on Appropriations of the House of Representatives</committee-name>; and</text></clause></subparagraph>
<subparagraph id="HFE631A61FEE9470F8CF8AE7DF9FC402"><enum>(B)</enum><text>publish such information in the Federal Register and on the Internet website of the Office of the Global AIDS Coordinator.</text></subparagraph></paragraph></subsection><after-quoted-block>.</after-quoted-block></quoted-block></paragraph></subsection>
<subsection id="H745A98D166724B44A767C7381E926C27"><enum>(e)</enum><header>Annual report</header><text>Section 104A(f) of such Act, as redesignated, is amended—</text>
<paragraph id="HDDCC5E91901147BBB5C38D4F005FF083"><enum>(1)</enum><text>in paragraph (1), by striking <quote>Committee on International Relations</quote> and inserting <quote>Committee on Foreign Affairs</quote>; and</text></paragraph>
<paragraph id="H838821F1148B49188E5E1FE90092A54"><enum>(2)</enum><text>in paragraph (2)—</text>
<subparagraph id="H9749A9AB00CA4B298C007806DA32EFE7"><enum>(A)</enum><text>in subparagraph (B), by striking <quote>and</quote> at the end;</text></subparagraph>
<subparagraph id="H414A6E1BEFF8411C8BD38BD9455146A7"><enum>(B)</enum><text>by striking subparagraph (C) and inserting the following:</text>
<quoted-block display-inline="no-display-inline" id="HFF73E73512D845E3913688DB6386B6D6" style="OLC">
<subparagraph id="H1059A1024CAE471DB3546B28A598F633"><enum>(C)</enum><text>a detailed breakdown of funding allocations, by program and by country, for prevention activities; and</text></subparagraph>
<subparagraph commented="no" display-inline="no-display-inline" id="HC38D680235FB4030B1B9E995634F3B3D"><enum>(D)</enum><text display-inline="yes-display-inline">a detailed assessment of the impact of programs established pursuant to such sections, including—</text>
<clause commented="no" display-inline="no-display-inline" id="HE36EFBE840CB45E98167659400001EEC"><enum>(i)</enum>
<subclause commented="no" display-inline="yes-display-inline" id="H4D250FC042E848938092224681ECDF93"><enum>(I)</enum><text>the effectiveness of such programs in reducing—</text>
<item commented="no" display-inline="no-display-inline" id="HD12FB527719641F59C88AB65FF159B39" indent="up1"><enum>(aa)</enum><text>the transmission of HIV, particularly in women and girls;</text></item>
<item commented="no" display-inline="no-display-inline" id="HC70926F754BE4BEDB2005BD829B38E39" indent="up1"><enum>(bb)</enum><text>mother-to-child transmission of HIV, including through drug treatment and therapies, either directly or by referral; and</text></item>
<item commented="no" display-inline="no-display-inline" id="HDD6A7D64C8B5448BA8E3BA3D92657EF0" indent="up1"><enum>(cc)</enum><text>mortality rates from HIV/AIDS;</text></item></subclause>
<subclause id="H3BDEAD4F0E864C62A3D29F2217CB8D2D" indent="up1"><enum>(II)</enum><text>the number of patients receiving treatment for AIDS in each country that receives assistance under this Act;</text></subclause>
<subclause id="HEC2F22AE8FB04CB5B9AFCA2ACD956B6" indent="up1"><enum>(III)</enum><text>an assessment of progress towards the achievement of annual goals set forth in the timetable required under the 5-year strategy established under section 101 of the <short-title>United States Leadership Against HIV/AIDS, Tuberculosis, and Malaria Act of 2003</short-title> and, if annual goals are not being met, the reasons for such failure; and</text></subclause>
<subclause id="HD5248D7BBBA7466CAC08C1F96DA7B8E0" indent="up1"><enum>(IV)</enum><text>retention and attrition data for programs receiving United States assistance, including mortality and loss to follow-up rates, organized overall and by country;</text></subclause></clause>
<clause commented="no" display-inline="no-display-inline" id="H8B5BAC0C5BBD404FA5C2B71BD8A8FB"><enum>(ii)</enum><text>the progress made toward—</text>
<subclause commented="no" display-inline="no-display-inline" id="H960D7F12828B4E359BDD5A97D9DE937"><enum>(I)</enum><text>improving health care delivery systems (including the training of health care workers, including doctors, nurses, midwives, pharmacists, laboratory technicians, and compensated community health workers, and the use of codes of conduct for ethical recruiting practices for health care workers);</text></subclause>
<subclause commented="no" display-inline="no-display-inline" id="H4484C83F93894AEC9100C48F0834E89C"><enum>(II)</enum><text>advancing safe working conditions for health care workers; and</text></subclause>
<subclause commented="no" display-inline="no-display-inline" id="HC5B649A8FF544CD500234FCC0921A1F0"><enum>(III)</enum><text>improving infrastructure to promote progress toward universal access to HIV/AIDS prevention, treatment, and care by 2013;</text></subclause></clause>
<clause id="HDD2A7C97A2F3435188BDB1F3F67F00AA"><enum>(iii)</enum><text>a description of coordination efforts with relevant executive branch agencies to link HIV/AIDS clinical and social services with non-HIV/AIDS services as part of the United States health and development agenda;</text></clause>
<clause id="H25D2C0CED8114527894BE94EFEECEAE"><enum>(iv)</enum><text>a detailed description of integrated HIV/AIDS and food and nutrition programs and services, including—</text>
<subclause id="HDE9AC1F93BAA437AA528007E002CF404"><enum>(I)</enum><text>the amount spent on food and nutrition support;</text></subclause>
<subclause id="H34EABA7D18034B22BC653F07F33E0300"><enum>(II)</enum><text>the types of activities supported; and</text></subclause>
<subclause id="H21CE876E475441D295A3B1BD7D20DD5E"><enum>(III)</enum><text>an assessment of the effectiveness of interventions carried out to improve the health status of persons with HIV/AIDS receiving food or nutritional support;</text></subclause></clause>
<clause id="H6B4BCAE63D1749959D00C47778A72662"><enum>(v)</enum><text>a description of efforts to improve harmonization, in terms of relevant executive branch agencies, coordination with other public and private entities, and coordination with partner countries’ national strategic plans as called for in the <quote>Three Ones</quote>;</text></clause>
<clause id="HBA17E564A38B4F448185085E3B97A915"><enum>(vi)</enum><text>a description of—</text>
<subclause id="HA4D6C3AF7DDB4CD7B8CDFD17A05305A1"><enum>(I)</enum><text>the efforts of partner countries that were signatories to the Abuja Declaration on HIV/AIDS, Tuberculosis and Other Related Infectious Diseases to adhere to the goals of such Declaration in terms of investments in public health, including HIV/AIDS; and</text></subclause>
<subclause id="HADDDFB526E054D2C8578F1B9B132D72F"><enum>(II)</enum><text>a description of the HIV/AIDS investments of partner countries that were not signatories to such Declaration;</text></subclause></clause>
<clause id="H03FE16A601A543A7AF73AF17FAD47B81"><enum>(vii)</enum><text>a detailed description of any compacts or framework agreements reached or negotiated between the United States and any partner countries, including a description of the elements of compacts described in subsection (e);</text></clause>
<clause id="H508BC4B1630C48D39B0021F614E2E81D"><enum>(viii)</enum><text>a description of programs serving women and girls, including—</text>
<subclause id="H2597085FF4E542DF8179788907D225C2"><enum>(I)</enum><text>HIV/AIDS prevention programs that address the vulnerabilities of girls and women to HIV/AIDS;</text></subclause>
<subclause id="H6580699D5E594A47AB87C999FC1EBDD2"><enum>(II)</enum><text>information on the number of individuals served by programs aimed at reducing the vulnerabilities of women and girls to HIV/AIDS and data on the types, objectives, and duration of programs to address these issues;</text></subclause>
<subclause id="H63A7489BEBE0455A9B39C7A93033DDB7"><enum>(III)</enum><text>information on programs to address the particular needs of adolescent girls and young women; and</text></subclause>
<subclause id="H82F43871BCB84ACD933D9724E303BFD2"><enum>(IV)</enum><text>programs to prevent gender-based violence or to assist victims of gender based violence as part of, or in coordination with, HIV/AIDS programs;</text></subclause></clause>
<clause id="H60772A45849C435BAF00BFD8E8AE7BA5"><enum>(ix)</enum><text>a description of strategies, goals, programs, and interventions to—</text>
<subclause id="H0680D3F0C4DD48AA8900288C4BB540DF"><enum>(I)</enum><text>address the needs and vulnerabilities of youth populations;</text></subclause>
<subclause id="H2771A1378BCE4981B1DE2EA135D7FAAA"><enum>(II)</enum><text>expand access among young men and women to evidence-based HIV/AIDS health care services and HIV prevention programs, including abstinence education programs; and</text></subclause>
<subclause id="H7AD8F81EB4CE47F183C100F1CF7D5933"><enum>(III)</enum><text>expand community-based services to meet the needs of orphans and of children and adolescents affected by or vulnerable to HIV/AIDS without increasing stigmatization;</text></subclause></clause>
<clause id="HD3C40CB2FB694AAEAEF3AF8BAEBF6B3F"><enum>(x)</enum><text>a description of—</text>
<subclause id="H88A283E6582D48138276A25BC20832D9"><enum>(I)</enum><text>the specific strategies funded to ensure the reduction of HIV infection among injection drug users;</text></subclause>
<subclause id="H9464FCD449E74386B9D45F8B78156666"><enum>(II)</enum><text>the number of injection drug users, by country, reached by such strategies; and</text></subclause>
<subclause id="HB6A44AE353E4474C83F69F3256BD93CE"><enum>(III)</enum><text>medication-assisted drug treatment for individuals with HIV or at risk of HIV;</text></subclause></clause>
<clause commented="no" display-inline="no-display-inline" id="H27C8A451211944DE81185128923C78A3"><enum>(xi)</enum><text>a detailed description of program monitoring, operations research, and impact evaluation research, including—</text>
<subclause commented="no" display-inline="no-display-inline" id="H744A2AD9A1DD4B7F9C4C93E8178C0026"><enum>(I)</enum><text>the amount of funding provided for each research type;</text></subclause>
<subclause commented="no" display-inline="no-display-inline" id="HFCE93C493F7543BA8F87420200E94E10"><enum>(II)</enum><text>an analysis of cost-effectiveness models; and</text></subclause>
<subclause commented="no" display-inline="no-display-inline" id="H66B2541E6B5A423FABB8BFE69F360087"><enum>(III)</enum><text>conclusions regarding the efficiency, effectiveness, and quality of services as derived from previous or ongoing research and monitoring efforts;</text></subclause></clause>
<clause id="H61464378052A46E1B24200C4F5B4B828"><enum>(xii)</enum><text>building capacity to identify, investigate, and stop nosocomial transmission of infectious diseases, including HIV and tuberculosis; and</text></clause>
<clause id="HE2748221D7034365AE5488B7579457D6"><enum>(xiii)</enum><text>a description of staffing levels of United States government HIV/AIDS teams in countries with significant HIV/AIDS programs, including whether or not a full-time coordinator was on staff for the year.</text></clause></subparagraph><after-quoted-block>.</after-quoted-block></quoted-block></subparagraph></paragraph></subsection>
<subsection id="H96604B4901F041708C2DF0F378391661"><enum>(f)</enum><header>Authorization of appropriations</header><text>Section 301(b) of the <short-title>United States Leadership Against HIV/AIDS, Tuberculosis, and Malaria Act of 2003</short-title> (<external-xref legal-doc="usc" parsable-cite="usc/22/7631">22 U.S.C. 7631(b)</external-xref>) is amended—</text>
<paragraph id="HDA57A4FE9273424D9DEE20FEB6FF713"><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="H8A84074B604841CBAD30D31446E8A8B"><enum>(2)</enum><text>in paragraph (3), by striking <quote>fiscal years 2004 through 2008</quote> and inserting <quote>fiscal years 2009 through 2013</quote>.</text></paragraph></subsection>
<subsection id="H4C4B6C58D0764AF7833D00F924F16E72"><enum>(g)</enum><header>Relationship To assistance programs To enhance nutrition</header><text>Section 301(c) of such Act is amended to read as follows:</text>
<quoted-block display-inline="no-display-inline" id="H4064EDEAB84D42DE8BCCFA240396BEE" style="OLC">
<subsection id="H9650B490D9CF4BB49438BF0237086660"><enum>(c)</enum><header>Food and nutritional support</header>
<paragraph id="H07B44D5046A34273B3D4A8CFB36C2951"><enum>(1)</enum><header>In general</header><text>As indicated in the report produced by the Institute of Medicine, entitled <quote>PEPFAR Implementation: Progress and Promise</quote>, inadequate caloric intake has been clearly identified as a principal reason for failure of clinical response to antiretroviral therapy. In recognition of the impact of malnutrition as a clinical health issue for many persons living with HIV/AIDS that is often associated with health and economic impacts on these individuals and their families, the Global AIDS Coordinator and the Administrator of the United States Agency for International Development shall—</text>
<subparagraph id="HAF50743A202347348D53B93D3F3EA700"><enum>(A)</enum><text>follow World Health Organization guidelines for HIV/AIDS food and nutrition services;</text></subparagraph>
<subparagraph id="H438D1DF95B44415DA3470000BFA5F4C"><enum>(B)</enum><text>integrate nutrition programs with HIV/AIDS activities through effective linkages among the health, agricultural, and livelihood sectors and establish additional services in circumstances in which referrals are inadequate or impossible;</text></subparagraph>
<subparagraph id="H1F3E5A0C1A144CBA9616E119424363FE"><enum>(C)</enum><text>provide, as a component of care and treatment programs for persons with HIV/AIDS, food and nutritional support to individuals infected with, and affected by, HIV/AIDS who meet established criteria for nutritional support (including clinically malnourished children and adults, and pregnant and lactating women in programs in need of supplemental support), including—</text>
<clause id="H774DEB6B4926456586E1E2C3A0000448"><enum>(i)</enum><text>anthropometric and dietary assessment;</text></clause>
<clause id="H100473E400704694AAC48295B8F3C4D4"><enum>(ii)</enum><text>counseling; and</text></clause>
<clause id="HFBBBFF3F9C24467F85FC6C58AD41D85F"><enum>(iii)</enum><text>therapeutic and supplementary feeding;</text></clause></subparagraph>
<subparagraph id="H7BD0FB1F787D4170856004A6A9059C0"><enum>(D)</enum><text>provide food and nutritional support for children affected by HIV/AIDS and to communities and households caring for children affected by HIV/AIDS; and</text></subparagraph>
<subparagraph id="H414707E5BCDA4C7B924100FB69F53EE6"><enum>(E)</enum><text>in communities where HIV/AIDS and food insecurity are highly prevalent, support programs to address these often intersecting health problems through community-based assistance programs, with an emphasis on sustainable approaches.</text></subparagraph></paragraph>
<paragraph id="HAC64133F0C4C47BABCB311D5CA8D9E72"><enum>(2)</enum><header>Authorization of appropriations</header><text>Of the amounts authorized to be appropriated under section 401, there are authorized to be appropriated to the President such sums as may be necessary for each of the fiscal years 2009 through 2013 to carry out this subsection.</text></paragraph></subsection><after-quoted-block>.</after-quoted-block></quoted-block></subsection>
<subsection id="H8AB50655DF514B40A814AEA72ED65C23"><enum>(h)</enum><header>Eligibility for assistance</header><text>Section 301(d) of such Act is amended to read as follows:</text>
<quoted-block display-inline="no-display-inline" id="H36813AED60304E1E8C525189B67E8690" style="OLC">
<subsection id="H0B38790ADDBC4140BF005D5859DC2640"><enum>(d)</enum><header>Eligibility for assistance</header><text>An organization, including a faith-based organization, that is otherwise eligible to receive assistance under section 104A of the Foreign Assistance Act of 1961, under this Act, or under any amendment made by this Act or by the <short-title>Tom Lantos and Henry J. Hyde United States Global Leadership Against HIV/AIDS, Tuberculosis, and Malaria Reauthorization Act of 2008</short-title>, for HIV/AIDS prevention, treatment, or care—</text>
<paragraph id="H587F76B67C804CFEAE5CBA049B49B1F9"><enum>(1)</enum><text>shall not be required, as a condition of receiving such assistance—</text>
<subparagraph id="HD848660955E343B5BCA6AF8779E80065"><enum>(A)</enum><text>to endorse or utilize a multisectoral or comprehensive approach to combating HIV/AIDS; or</text></subparagraph>
<subparagraph id="H9674CD8114BB49C600868CE7EB425B25"><enum>(B)</enum><text>to endorse, utilize, make a referral to, become integrated with, or otherwise participate in any program or activity to which the organization has a religious or moral objection; and</text></subparagraph></paragraph>
<paragraph id="HD55189B3174B4BFDBDBB6B6DE1D497CF"><enum>(2)</enum><text>shall not be discriminated against in the solicitation or issuance of grants, contracts, or cooperative agreements under such provisions of law for refusing to meet any requirement described in paragraph (1).</text></paragraph></subsection><after-quoted-block>.</after-quoted-block></quoted-block></subsection></section>
<section id="H89213957D54F4C149FDF22668087A428"><enum>302.</enum><header>Assistance to combat tuberculosis</header>
<subsection id="HF114B6E86C774F29A1965670D2D2F895"><enum>(a)</enum><header>Policy</header><text>Section 104B(b) of the Foreign Assistance Act of 1961 (<external-xref legal-doc="usc" parsable-cite="usc/22/2151b-3">22 U.S.C. 2151b–3(b)</external-xref>) is amended to read as follows:</text>
<quoted-block display-inline="no-display-inline" id="H3937B6AED9964AAFA5AD9635F19562E2" style="OLC">
<subsection id="HA01F7E9F18024FD29DF857B9D0DBBA89"><enum>(b)</enum><header>Policy</header><text>It is a major objective of the foreign assistance program of the United States to control tuberculosis. In all countries in which the Government of the United States has established development programs, particularly in countries with the highest burden of tuberculosis and other countries with high rates of tuberculosis, the United States should support the objectives of the Global Plan to Stop TB, including through achievement of the following goals:</text>
<paragraph id="H246DEC4AB6544FD59755FD340300B7B4"><enum>(1)</enum><text>Reduce by half the tuberculosis death and disease burden from the 1990 baseline.</text></paragraph>
<paragraph id="H5B47E9A1A6DD4974A3B360BEEDBE63FF"><enum>(2)</enum><text>Sustain or exceed the detection of at least 70 percent of sputum smear-positive cases of tuberculosis and the successful treatment of at least 85 percent of the cases detected in countries with established United States Agency for International Development tuberculosis programs.</text></paragraph>
<paragraph id="HD35DC4CFF0D8488FB78E4F3F6D5EFAFD"><enum>(3)</enum><text>In support of the Global Plan to Stop TB, the President shall establish a comprehensive, 5-year United States strategy to expand and improve United States efforts to combat tuberculosis globally, including a plan to support—</text>
<subparagraph id="HC387918F754549FE9843247FE6C8562E"><enum>(A)</enum><text>the successful treatment of 4,500,000 new sputum smear tuberculosis patients under DOTS programs by 2013, primarily through direct support for needed services, commodities, health workers, and training, and additional treatment through coordinated multilateral efforts; and</text></subparagraph>
<subparagraph id="HC6A1549709994E85B4F844E18FF5F1A7"><enum>(B)</enum><text>the diagnosis and treatment of 90,000 new multiple drug resistant tuberculosis cases by 2013, and additional treatment through coordinated multilateral efforts.</text></subparagraph></paragraph></subsection><after-quoted-block>.</after-quoted-block></quoted-block></subsection>
<subsection id="H4A563C238BAC42B7BBDEAF4C7509AD36"><enum>(b)</enum><header>Priority To Stop TB Strategy</header><text>Section 104B(e) of such Act is amended to read as follows:</text>
<quoted-block display-inline="no-display-inline" id="H2AEAB22F7B5D4716A077C90718FAE6C9" style="OLC">
<subsection id="H85F45899D3D3459EBD1DC6283BBB0019"><enum>(e)</enum><header>Priority To Stop TB Strategy</header><text>In furnishing assistance under subsection (c), the President shall give priority to—</text>
<paragraph id="HA74BEF5C966141E4B3651E007783A7D3"><enum>(1)</enum><text>direct services described in the Stop TB Strategy, including expansion and enhancement of Directly Observed Treatment Short-course (DOTS) coverage, rapid testing, treatment for individuals infected with both tuberculosis and HIV, and treatment for individuals with multi-drug resistant tuberculosis (MDR–TB), strengthening of health systems, use of the International Standards for Tuberculosis Care by all providers, empowering individuals with tuberculosis, and enabling and promoting research to develop new diagnostics, drugs, and vaccines, and program-based operational research relating to tuberculosis; and</text></paragraph>
<paragraph id="H6C5C36676B9D42B4B775353447975CD"><enum>(2)</enum><text>funding for the Global Tuberculosis Drug Facility, the Stop Tuberculosis Partnership, and the Global Alliance for TB Drug Development.</text></paragraph></subsection><after-quoted-block>.</after-quoted-block></quoted-block></subsection>
<subsection id="H75338971DDBB44039CC836BDB2A3D134"><enum>(c)</enum><header>Assistance for the World Health Organization and the Stop Tuberculosis Partnership</header><text>Section 104B of such Act is amended—</text>
<paragraph id="HA596C1A0027140C3A5AE540095765C87"><enum>(1)</enum><text>by redesignating subsection (f) as subsection (h); and</text></paragraph>
<paragraph id="H7887D82CB01A4EDCA8BC1904343E77CF"><enum>(2)</enum><text>by inserting after subsection (e) the following:</text>
<quoted-block display-inline="no-display-inline" id="HF76CFDBB7EE242E88956114153B7D379" style="OLC">
<subsection id="H2772A9865DD248C49227717964B4DBB8"><enum>(f)</enum><header>Assistance for the World Health Organization and the Stop Tuberculosis Partnership</header><text>In carrying out this section, the President, acting through the Administrator of the United States Agency for International Development, is authorized to provide increased resources to the World Health Organization and the Stop Tuberculosis Partnership to improve the capacity of countries with high rates of tuberculosis and other affected countries to implement the Stop TB Strategy and specific strategies related to addressing multiple drug resistant tuberculosis (MDR–TB) and extensively drug resistant tuberculosis (XDR–TB).</text></subsection><after-quoted-block>.</after-quoted-block></quoted-block></paragraph></subsection>
<subsection id="H144CFFA7AD934F57871FF11DCB49857E"><enum>(d)</enum><header>Annual report</header><text>Section 104B of such Act is amended by inserting after subsection (f), as added by subsection (c) of this section, the following:</text>
<quoted-block display-inline="no-display-inline" id="H71550F79ED9C4E848C574CAB17DD93FD" style="OLC">
<subsection id="H7650F611D5154B5B8D4C972B6819C747"><enum>(g)</enum><header>Annual report</header><text>The President shall submit an annual report to Congress that describes the impact of United States foreign assistance on efforts to control tuberculosis, including—</text>
<paragraph id="H333B2F308CFF4400A0CE1F947DDC498F"><enum>(1)</enum><text>the number of tuberculosis cases diagnosed and the number of cases cured in countries receiving United States bilateral foreign assistance for tuberculosis control purposes;</text></paragraph>
<paragraph id="H1192D750BD0842F68D0816303E350608"><enum>(2)</enum><text>a description of activities supported with United States tuberculosis resources in each country, including a description of how those activities specifically contribute to increasing the number of people diagnosed and treated for tuberculosis;</text></paragraph>
<paragraph id="HBB5A9B6645C54363A14CD953C4415168"><enum>(3)</enum><text>in each country receiving bilateral United States foreign assistance for tuberculosis control purposes, the percentage provided for direct tuberculosis services in countries receiving United States bilateral foreign assistance for tuberculosis control purposes;</text></paragraph>
<paragraph id="HEDFCAFD8DB9D4329A9893F00D2615CC2"><enum>(4)</enum><text>a description of research efforts and clinical trials to develop new tools to combat tuberculosis, including diagnostics, drugs, and vaccines supported by United States bilateral assistance;</text></paragraph>
<paragraph id="H9E62DE376A08409AB4BF4433305D86BA"><enum>(5)</enum><text>the number of persons who have been diagnosed and started treatment for multidrug-resistant tuberculosis in countries receiving United States bilateral foreign assistance for tuberculosis control programs;</text></paragraph>
<paragraph id="H19A20CD176DC40C9A905C2935E227CD2"><enum>(6)</enum><text>a description of the collaboration and coordination of United States anti-tuberculosis efforts with the World Health Organization, the Global Fund, and other major public and private entities within the Stop TB Strategy;</text></paragraph>
<paragraph id="H33E2E071044C48A8BA53AE50329814DE"><enum>(7)</enum><text>the constraints on implementation of programs posed by health workforce shortages and capacities;</text></paragraph>
<paragraph id="H70904DF609954C9CA04DE05DC2B00030"><enum>(8)</enum><text>the number of people trained in tuberculosis control; and</text></paragraph>
<paragraph id="HF1E47DC236984F52B35F8DC45DDDD527"><enum>(9)</enum><text>a breakdown of expenditures for direct patient tuberculosis services, drugs and other commodities, drug management, training in diagnosis and treatment, health systems strengthening, research, and support costs.</text></paragraph></subsection><after-quoted-block>.</after-quoted-block></quoted-block></subsection>
<subsection id="HCEA84A414EAA41FCA9E0E79167A0C9F7"><enum>(e)</enum><header>Definitions</header><text>Section 104B(h) of such Act, as redesignated by subsection (c), is amended—</text>
<paragraph id="HF327AFAC30FC490C80A31E8823928C48"><enum>(1)</enum><text>in paragraph (1), by striking the period at the end and inserting the following: “including—</text>
<quoted-block display-inline="no-display-inline" id="H346A840C348C4C499F8072007DBD6214" style="OLC">
<subparagraph id="HA626DDC5E5EF43DB99A46454FA3F06D0"><enum>(A)</enum><text>low-cost and effective diagnosis, treatment, and monitoring of tuberculosis;</text></subparagraph>
<subparagraph id="H337929CAE4A64CC89E475DB7E74641B5"><enum>(B)</enum><text>a reliable drug supply;</text></subparagraph>
<subparagraph id="H77605EEFCADC43C49F31090034C44167"><enum>(C)</enum><text>a management strategy for public health systems;</text></subparagraph>
<subparagraph id="H0AFE8A0853D94C4FBF5FD5922CAD6600"><enum>(D)</enum><text>health system strengthening;</text></subparagraph>
<subparagraph id="H7D6E79FD16C0431F981D34657F9CD7A0"><enum>(E)</enum><text>promotion of the use of the International Standards for Tuberculosis Care by all care providers;</text></subparagraph>
<subparagraph id="HBC80A1E5BF564261BE9F8D6CF55D19FA"><enum>(F)</enum><text>bacteriology under an external quality assessment framework;</text></subparagraph>
<subparagraph id="H00FAEF87B09A4955998253AAE65D57DC"><enum>(G)</enum><text>short-course chemotherapy; and</text></subparagraph>
<subparagraph id="H8BDFFF03E5934CC6006E8715C0A5422E"><enum>(H)</enum><text>sound reporting and recording systems.</text></subparagraph><after-quoted-block>; and</after-quoted-block></quoted-block></paragraph>
<paragraph id="HD8CD70AD1CA44C60A43600E6B3DF6D"><enum>(2)</enum><text>by redesignating paragraph (5) as paragraph (6); and</text></paragraph>
<paragraph id="HD06F010213B74222B48FCD93B928C19B"><enum>(3)</enum><text>by inserting after paragraph (4) the following:</text>
<quoted-block display-inline="no-display-inline" id="H364AA2AE154F4199884251995FD0AE76" style="OLC">
<paragraph id="HFFE6648BD3B8417BA4CD02FF3B071FC4"><enum>(5)</enum><header>Stop TB strategy</header><text>The term <term>Stop TB Strategy</term> means the 6-point strategy to reduce tuberculosis developed by the World Health Organization, which is described in the Global Plan to Stop TB 2006–2015: Actions for Life, a comprehensive plan developed by the Stop TB Partnership that sets out the actions necessary to achieve the millennium development goal of cutting tuberculosis deaths and disease burden in half by 2015.</text></paragraph><after-quoted-block>.</after-quoted-block></quoted-block></paragraph></subsection>
<subsection id="HD9D6FD9CD25640CB94F342FA8E027852"><enum>(f)</enum><header>Authorization of appropriations</header><text>Section 302 (b) of the <short-title>United States Leadership Against HIV/AIDS, Tuberculosis, and Malaria Act of 2003</short-title> (<external-xref legal-doc="usc" parsable-cite="usc/22/7632">22 U.S.C. 7632(b)</external-xref>) is amended—</text>
<paragraph id="H7365DE21CE51406FAB86A626BCCC1F20"><enum>(1)</enum><text>in paragraph (1), by striking <quote>such sums as may be necessary for each of the fiscal years 2004 through 2008</quote> and inserting <quote>a total of $4,000,000,000 for the 5-year period beginning on October 1, 2008.</quote>; and</text></paragraph>
<paragraph id="H8562EFD34D824824AED0007674D7FF75"><enum>(2)</enum><text>in paragraph (3), by striking <quote>fiscal years 2004 through 2008</quote> and inserting <quote>fiscal years 2009 through 2013.</quote>.</text></paragraph></subsection></section>
<section id="HE26DE57F1624465FBDB664E9ADA11741"><enum>303.</enum><header>Assistance to combat malaria</header>
<subsection id="H475F417FC9254274B89D8844FEF1D7DA"><enum>(a)</enum><header>Amendment to the Foreign Assistance Act of 1961</header><text>Section 104C(b) of the Foreign Assistance Act of 1961 (<external-xref legal-doc="usc" parsable-cite="usc/22/2151-4">22 U.S.C. 2151–4(b)</external-xref>) is amended by inserting <quote>treatment,</quote> after <quote>control,</quote>.</text></subsection>
<subsection id="HFE834C640A1540CB8B3C3C45B8DE0000"><enum>(b)</enum><header>Authorization of Appropriations</header><text>Section 303 of the <short-title>United States Leadership Against HIV/AIDS, Tuberculosis, and Malaria Act of 2003</short-title>, and Malaria Act of 2003 (<external-xref legal-doc="usc" parsable-cite="usc/22/7633">22 U.S.C. 7633</external-xref>) is amended—</text>
<paragraph id="HD035C3BBACEF425DA25562F0C909D068"><enum>(1)</enum><text>in subsection (b)—</text>
<subparagraph id="H4AA76C38E8E345EF9235E07D2CD177E0"><enum>(A)</enum><text>in paragraph (1), by striking <quote>such sums as may be necessary for fiscal years 2004 through 2008</quote> and inserting <quote>$5,000,000,000 during the 5-year period beginning on October 1, 2008</quote>; and</text></subparagraph>
<subparagraph id="H8B5034187C2A4180B0CFE3605865AD02"><enum>(B)</enum><text>in paragraph (3), by striking <quote>fiscal years 2004 through 2008</quote> and inserting <quote>fiscal years 2009 through 2013</quote>; and</text></subparagraph></paragraph>
<paragraph id="H2885FF5854894FE695144BAFCEFC19EF"><enum>(2)</enum><text>by adding at the end the following:</text>
<quoted-block display-inline="no-display-inline" id="H3017D5510CE441329FED8C5B2E77A889" style="OLC">
<subsection id="HA44F6D294CE8405F8E2657E6AF65948B"><enum>(c)</enum><header>Statement of policy</header><text>Providing assistance for the prevention, control, treatment, and the ultimate eradication of malaria is—</text>
<paragraph id="H57C5030FBE9841A880B7579040DFC578"><enum>(1)</enum><text>a major objective of the foreign assistance program of the United States; and</text></paragraph>
<paragraph id="HFC8432FEDC354B7085532E8DF536A121"><enum>(2)</enum><text>1 component of a comprehensive United States global health strategy to reduce disease burdens and strengthen communities around the world.</text></paragraph></subsection>
<subsection id="H0C9C00B7A90A4252978B87F8701C3FC"><enum>(d)</enum><header>Development of a Comprehensive 5-Year Strategy</header><text>The President shall establish a comprehensive, 5-year strategy to combat global malaria that—</text>
<paragraph id="H965DFB18E1A54AB0931F9DB4524BA8BB"><enum>(1)</enum><text>strengthens the capacity of the United States to be an effective leader of international efforts to reduce malaria burden;</text></paragraph>
<paragraph id="H101F06FCDFFD4EE09E83C15649F95489"><enum>(2)</enum><text>maintains sufficient flexibility and remains responsive to the ever-changing nature of the global malaria challenge;</text></paragraph>
<paragraph id="H59243836360C44A19F09D3024220F0CC"><enum>(3)</enum><text>includes specific objectives and multisectoral approaches and strategies to reduce the prevalence, mortality, incidence, and spread of malaria;</text></paragraph>
<paragraph id="HAB392B0F4EFD4B5BBB50B5210348EEAC"><enum>(4)</enum><text>describes how this strategy would contribute to the United States’ overall global health and development goals;</text></paragraph>
<paragraph id="H58744E2572954FA8AC127BA0649DE12F"><enum>(5)</enum><text>clearly explains how outlined activities will interact with other United States Government global health activities, including the 5-year global AIDS strategy required under this Act;</text></paragraph>
<paragraph id="H733AD40188C945F3976F9283AAE2657D"><enum>(6)</enum><text>expands public-private partnerships and leverage of resources;</text></paragraph>
<paragraph id="HE4E11D89076A417B9B011D084E947432"><enum>(7)</enum><text>coordinates among relevant Federal agencies to maximize human and financial resources and to reduce duplication among these agencies, foreign governments, and international organizations;</text></paragraph>
<paragraph id="H577182A36F664312894E9B989571C681"><enum>(8)</enum><text>coordinates with other international entities, including the Global Fund;</text></paragraph>
<paragraph id="HD0AD8E771143454ABF9513E279244324"><enum>(9)</enum><text>maximizes United States capabilities in the areas of technical assistance and training and research, including vaccine research; and</text></paragraph>
<paragraph id="H762A370DE6D7431983BCD97C72F3EA2B"><enum>(10)</enum><text>establishes priorities and selection criteria for the distribution of resources based on factors such as—</text>
<subparagraph id="H421C663784B0448281262B94656ECF11"><enum>(A)</enum><text>the size and demographics of the population with malaria;</text></subparagraph>
<subparagraph id="HAD51CCAEBBCB4DD9838D005964EEAC3C"><enum>(B)</enum><text>the needs of that population;</text></subparagraph>
<subparagraph id="HEDD8F876C5E5471EB187A9B09D8D6692"><enum>(C)</enum><text>the country’s existing infrastructure; and</text></subparagraph>
<subparagraph id="H229423B45ED4478B8D83A016B76EF61"><enum>(D)</enum><text>the ability to closely coordinate United States Government efforts with national malaria control plans of partner countries.</text></subparagraph></paragraph></subsection><after-quoted-block>.</after-quoted-block></quoted-block></paragraph></subsection></section>
<section id="HEDBA1270FD1648B08D1364BF5B6B501B"><enum>304.</enum><header>Malaria Response Coordinator</header><text display-inline="no-display-inline">Section 304 of the <short-title>United States Leadership Against HIV/AIDS, Tuberculosis, and Malaria Act of 2003</short-title> (<external-xref legal-doc="usc" parsable-cite="usc/22/7634">22 U.S.C. 7634</external-xref>) is amended to read as follows:</text>
<quoted-block display-inline="no-display-inline" id="H87444DCF863F49ED88C2214BF8576929" style="OLC">
<section id="H5D9D363AFB2447A4BC01F30074F58931"><enum>304.</enum><header>Malaria Response Coordinator</header>
<subsection id="H930DDAD27CDC48D19EFEE2C3C5EF99D"><enum>(a)</enum><header>In general</header><text>There is established within the United States Agency for International Development a Coordinator of United States Government Activities to Combat Malaria Globally (referred to in this section as the <quote>Malaria Coordinator</quote>), who shall be appointed by the President.</text></subsection>
<subsection id="HAC59290C2F274043B72CF99164B63E30"><enum>(b)</enum><header>Authorities</header><text>The Malaria Coordinator, acting through nongovernmental organizations (including faith-based and community-based organizations), partner country finance, health, and other relevant ministries, and relevant executive branch agencies as may be necessary and appropriate to carry out this section, is authorized to—</text>
<paragraph id="H3B6ECEEC143C43E990F878D81301A5EC"><enum>(1)</enum><text>operate internationally to carry out prevention, care, treatment, support, capacity development, and other activities to reduce the prevalence, mortality, and incidence of malaria;</text></paragraph>
<paragraph id="H29EB026AE0FA432997A52FE2BE2D76A4"><enum>(2)</enum><text>provide grants to, and enter into contracts and cooperative agreements with, nongovernmental organizations (including faith-based organizations) to carry out this section; and</text></paragraph>
<paragraph id="H3F2A7E6F13F2409AA5383DC3D24B683E"><enum>(3)</enum><text>transfer and allocate executive branch agency funds that have been appropriated for the purposes described in paragraphs (1) and (2).</text></paragraph></subsection>
<subsection id="H7D14DAB049A7441C8CED6B4CC7BCFD"><enum>(c)</enum><header>Duties</header>
<paragraph id="HE8837B5DBF754E2FB2C5DC7814BA66A6"><enum>(1)</enum><header>In general</header><text>The Malaria Coordinator has primary responsibility for the oversight and coordination of all resources and international activities of the United States Government relating to efforts to combat malaria.</text></paragraph>
<paragraph id="H1D7D33B3213740EC904B45931F90B857"><enum>(2)</enum><header>Specific duties</header><text>The Malaria Coordinator shall—</text>
<subparagraph id="H318ED43F3A6B4DF8A0FD974898067663"><enum>(A)</enum><text>facilitate program and policy coordination of antimalarial efforts among relevant executive branch agencies and nongovernmental organizations by auditing, monitoring, and evaluating such programs;</text></subparagraph>
<subparagraph id="H0048DF68955045918344F4DCA2B700B4"><enum>(B)</enum><text>ensure that each relevant executive branch agency undertakes antimalarial programs primarily in those areas in which the agency has the greatest expertise, technical capability, and potential for success;</text></subparagraph>
<subparagraph id="HDE909BAC5BE7425EB02B8352F52F6170"><enum>(C)</enum><text>coordinate relevant executive branch agency activities in the field of malaria prevention and treatment;</text></subparagraph>
<subparagraph id="H62F80FFF7B884BF187995888879DF723"><enum>(D)</enum><text>coordinate planning, implementation, and evaluation with the Global AIDS Coordinator in countries in which both programs have a significant presence;</text></subparagraph>
<subparagraph id="H4ADCFE18023B41F1B752E3FE4FBACE44"><enum>(E)</enum><text>coordinate with national governments, international agencies, civil society, and the private sector; and</text></subparagraph>
<subparagraph id="H1ACED010875046CFB3F3472B2226EBD0"><enum>(F)</enum><text>establish due diligence criteria for all recipients of funds appropriated by the Federal Government for malaria assistance.</text></subparagraph></paragraph></subsection>
<subsection id="HDBCB1BC81B7B46EB91725FC399A2B3A2"><enum>(d)</enum><header>Assistance for the World Health Organization</header><text>In carrying out this section, the President may provide financial assistance to the Roll Back Malaria Partnership of the World Health Organization to improve the capacity of countries with high rates of malaria and other affected countries to implement comprehensive malaria control programs.</text></subsection>
<subsection id="H71FD0EA3941941429E05D09930D42189"><enum>(e)</enum><header>Coordination of Assistance Efforts</header><text>In carrying out this section and in accordance with section 104C of the Foreign Assistance Act of 1961 (<external-xref legal-doc="usc" parsable-cite="usc/22/2151b-4">22 U.S.C. 2151b–4</external-xref>), the Malaria Coordinator shall coordinate the provision of assistance by working with—</text>
<paragraph id="H1E21E1DFBB5541C5841BB7DD0864FC1"><enum>(1)</enum><text>relevant executive branch agencies, including—</text>
<subparagraph id="HC4D8375E1FBD44B99B9F7D88DE00D7C0"><enum>(A)</enum><text>the Department of State (including the Office of the Global AIDS Coordinator);</text></subparagraph>
<subparagraph id="H12710480632E4BDBBC49CDB76C25584B"><enum>(B)</enum><text>the Department of Health and Human Services;</text></subparagraph>
<subparagraph id="H5A808ABF7AB34A959540F70098AE3F99"><enum>(C)</enum><text>the Department of Defense; and</text></subparagraph>
<subparagraph id="HF7C038C08D9044018C4DF7D8F38E3F"><enum>(D)</enum><text>the Office of the United States Trade Representative;</text></subparagraph></paragraph>
<paragraph id="HE34325E233EE4E81B60623EA712C3D4E"><enum>(2)</enum><text>relevant multilateral institutions, including—</text>
<subparagraph id="HEDE411B430DE47659744E33C008B6C9B"><enum>(A)</enum><text>the World Health Organization;</text></subparagraph>
<subparagraph id="HB0CF4049DD7A4A43A09DC6FA042C4F64"><enum>(B)</enum><text>the United Nations Children’s Fund;</text></subparagraph>
<subparagraph id="HC2438036F93E4C5AAD5CE191099C44FB"><enum>(C)</enum><text>the United Nations Development Programme;</text></subparagraph>
<subparagraph id="H493B930F8D554B49A2DACBEFE3CE4D51"><enum>(D)</enum><text>the Global Fund;</text></subparagraph>
<subparagraph id="H9895CE37BEEE4923AF3D02685C719F10"><enum>(E)</enum><text>the World Bank; and</text></subparagraph>
<subparagraph id="H5AEFB380CDA44F97B5385DF2366C60B1"><enum>(F)</enum><text>the Roll Back Malaria Partnership;</text></subparagraph></paragraph>
<paragraph id="H56B899E6993E4763A1CD2B52519888E6"><enum>(3)</enum><text>program delivery and efforts to lift barriers that would impede effective and comprehensive malaria control programs; and</text></paragraph>
<paragraph id="H2A3D12D8FD254302A57C244DD680BF35"><enum>(4)</enum><text>partner or recipient country governments and national entities including universities and civil society organizations (including faith- and community-based organizations).</text></paragraph></subsection>
<subsection id="HA5E6BE902F7D40A78838B122AA9B22F"><enum>(f)</enum><header>Research</header><text>To carry out this section, the Malaria Coordinator, in accordance with section 104C of the Foreign Assistance Act of 1961 (<external-xref legal-doc="usc" parsable-cite="usc/22/1151d-4">22 U.S.C. 1151d–4</external-xref>), shall ensure that operations and implementation research conducted under this Act will closely complement the clinical and program research being undertaken by the National Institutes of Health. The Centers for Disease Control and Prevention should advise the Malaria Coordinator on priorities for operations and implementation research and should be a key implementer of this research.</text></subsection>
<subsection id="H5CAE7F92B04741E8B2C8BCDC006DD89"><enum>(g)</enum><header>Monitoring</header><text>To ensure that adequate malaria controls are established and implemented, the Centers for Disease Control and Prevention should advise the Malaria Coordinator on monitoring, surveillance, and evaluation activities and be a key implementer of such activities under this Act. Such activities shall complement, rather than duplicate, the work of the World Health Organization.</text></subsection>
<subsection id="HA59782C634294DF0A73058E6171DBFA7"><enum>(h)</enum><header>Annual report</header>
<paragraph id="HB5A215457BDC46A3B05FF4F7CEB290CA"><enum>(1)</enum><header>Submission</header><text>Not later than 1 year after the date of the enactment of the <short-title>Tom Lantos and Henry J. Hyde United States Global Leadership Against HIV/AIDS, Tuberculosis, and Malaria Reauthorization Act of 2008</short-title>, and annually thereafter, the President shall submit a report to the appropriate congressional committees that describes United States assistance for the prevention, treatment, control, and elimination of malaria.</text></paragraph>
<paragraph id="H200258ADB0434D23B12EF0ED9036A9A4"><enum>(2)</enum><header>Contents</header><text>The report required under paragraph (1) shall describe—</text>
<subparagraph id="HDD01C5B254CE428DBBE800C700C4AB57"><enum>(A)</enum><text>the countries and activities to which malaria resources have been allocated;</text></subparagraph>
<subparagraph id="H670EDF30C13D426EB78E177FFD759839"><enum>(B)</enum><text>the number of people reached through malaria assistance programs, including data on children and pregnant women;</text></subparagraph>
<subparagraph id="HDFBF931BB946440E9CD66090AAC4E1C7"><enum>(C)</enum><text>research efforts to develop new tools to combat malaria, including drugs and vaccines;</text></subparagraph>
<subparagraph id="H5756A7E3E0F340F900365B5835845979"><enum>(D)</enum><text>the collaboration and coordination of United States antimalarial efforts with the World Health Organization, the Global Fund, the World Bank, other donor governments, major private efforts, and relevant executive agencies;</text></subparagraph>
<subparagraph id="HFE405C0E9D8F4293B819DF39F3742954"><enum>(E)</enum><text>the coordination of United States antimalarial efforts with the national malarial strategies of other donor or partner governments and major private initiatives;</text></subparagraph>
<subparagraph id="HA42B5CE5027045F79D1F096DAE157433"><enum>(F)</enum><text>the estimated impact of United States assistance on childhood mortality and morbidity from malaria;</text></subparagraph>
<subparagraph id="H178F6FE0CFE74F6CAE1D725C2200E88D"><enum>(G)</enum><text>the coordination of antimalarial efforts with broader health and development programs; and</text></subparagraph>
<subparagraph id="HDF1E24977C3945EDB02B45BF42D831A3"><enum>(H)</enum><text>the constraints on implementation of programs posed by health workforce shortages or capacities; and</text></subparagraph>
<subparagraph id="H49386D3F9F464A22B251A530706DE37C"><enum>(I)</enum><text>the number of personnel trained as health workers and the training levels achieved.</text></subparagraph></paragraph></subsection></section><after-quoted-block>.</after-quoted-block></quoted-block></section>
<section id="HAEF03E49044542C596ABC6321EDBDD7"><enum>305.</enum><header>Amendment to Immigration and Nationality Act</header><text display-inline="no-display-inline">Section 212(a)(1)(A)(i) of the Immigration and Nationality Act (<external-xref legal-doc="usc" parsable-cite="usc/8/1182">8 U.S.C. 1182(a)(1)(A)(i)</external-xref>) is amended by striking <quote>, which shall include infection with the etiologic agent for acquired immune deficiency syndrome,</quote> and inserting a semicolon.</text></section>
<section id="H93C58BF740B74E408C910069F0D1E6D3"><enum>306.</enum><header>Clerical amendment</header><text display-inline="no-display-inline">Title III of the <short-title>United States Leadership Against HIV/AIDS, Tuberculosis, and Malaria Act of 2003</short-title> (<external-xref legal-doc="usc" parsable-cite="usc/22/7631">22 U.S.C. 7631 et seq.</external-xref>) is amended by striking the heading for subtitle B and inserting the following:</text>
<quoted-block display-inline="no-display-inline" id="HBC2F9049F43A4AA88189B09547EC8F9C" style="OLC">
<subtitle id="HF8554A5B765C486FA3E4D631CB52B022"><enum>B</enum><header>Assistance for women, children, and families</header></subtitle><after-quoted-block>.</after-quoted-block></quoted-block></section>
<section id="H49449E86DA3A423D863B76A14B24F2EE"><enum>307.</enum><header>Requirements</header><text display-inline="no-display-inline">Section 312(b) of the <short-title>United States Leadership Against HIV/AIDS, Tuberculosis, and Malaria Act of 2003</short-title> (<external-xref legal-doc="usc" parsable-cite="usc/22/7652">22 U.S.C. 7652(b)</external-xref>) is amended by striking paragraphs (1), (2), and (3) and inserting the following:</text>
<quoted-block display-inline="no-display-inline" id="H7A0B86CE57224678913558905C05C15C" style="OLC">
<paragraph id="H4122BA933682466181709100C9478C66"><enum>(1)</enum><text>establish a target for the prevention and treatment of mother-to-child transmission of HIV that, by 2013, will reach at least 80 percent of pregnant women in those countries most affected by HIV/AIDS in which the United States has HIV/AIDS programs;</text></paragraph>
<paragraph id="H781CC1E65605424FBF797E7E54E5C9D8"><enum>(2)</enum><text>establish a target that, by 2013, the proportion of children receiving care and treatment under this Act is proportionate to their numbers within the population of HIV infected individuals in each country;</text></paragraph>
<paragraph id="H99518DED77F8485C88018C3FFCC16185"><enum>(3)</enum><text>integrate care and treatment with prevention of mother-to-child transmission of HIV programs to improve outcomes for HIV-affected women and families as soon as is feasible and support strategies that promote successful follow-up and continuity of care of mother and child;</text></paragraph>
<paragraph id="HC58F7602E1374E1E9EB43D3E0054B308"><enum>(4)</enum><text>expand programs designed to care for children orphaned by, affected by, or vulnerable to HIV/AIDS;</text></paragraph>
<paragraph id="HD2A6781D4969444BA2C92402F7C5E1A9"><enum>(5)</enum><text>ensure that women in prevention of mother-to-child transmission of HIV programs are provided with, or referred to, appropriate maternal and child services; and</text></paragraph>
<paragraph id="H10E0BB1F5CF948A69511D09308A7DE3"><enum>(6)</enum><text>develop a timeline for expanding access to more effective regimes to prevent mother-to-child transmission of HIV, consistent with the national policies of countries in which programs are administered under this Act and the goal of achieving universal use of such regimes as soon as possible.</text></paragraph><after-quoted-block>.</after-quoted-block></quoted-block></section>
<section id="HBF2571B471684FB79C8BFD08006F5700"><enum>308.</enum><header>Annual report on prevention of mother-to-child transmission of HIV</header><text display-inline="no-display-inline">Section 313(a) of the <short-title>United States Leadership Against HIV/AIDS, Tuberculosis, and Malaria Act of 2003</short-title> (<external-xref legal-doc="usc" parsable-cite="usc/22/7653">22 U.S.C. 7653(a)</external-xref>) is amended by striking <quote>5 years</quote> and inserting <quote>10 years</quote>.</text></section>
<section id="H82CB7B371ADA4522AF22F922B1DFD23"><enum>309.</enum><header>Prevention of mother-to-child transmission expert panel</header><text display-inline="no-display-inline">Section 312 of the United States Leadership Against HIV/AIDS, Tuberculosis, and Malaria Act of 2003 (<external-xref legal-doc="usc" parsable-cite="usc/22/7652">22 U.S.C. 7652</external-xref>) is amended by adding at the end the following:</text>
<quoted-block display-inline="no-display-inline" id="H71D112E90D824C518F974BCC3DDE6E4" style="OLC">
<subsection id="H5A8AD64ED1A148BFBBA92881788DDE75"><enum>(c)</enum><header>Prevention of mother-to-child transmission expert panel</header>
<paragraph id="H778D80EE78E948C1A4654EA4A4E76D55"><enum>(1)</enum><header>Establishment</header><text>The Global AIDS Coordinator shall establish a panel of experts to be known as the Prevention of Mother-to-Child Transmission Panel (referred to in this subsection as the <quote>Panel</quote>) to—</text>
<subparagraph id="H8ABCF609D9064CE6A6D02829F52C13B2"><enum>(A)</enum><text>provide an objective review of activities to prevent mother-to-child transmission of HIV; and</text></subparagraph>
<subparagraph id="H21FEA3E2AD504844969585BD058098AE"><enum>(B)</enum><text>provide recommendations to the Global AIDS Coordinator and to the appropriate congressional committees for scale-up of mother-to-child transmission prevention services under this Act in order to achieve the target established in subsection (b)(1).</text></subparagraph></paragraph>
<paragraph id="H770DFD2590BB4B6D86BF3E92806CCFAC"><enum>(2)</enum><header>Membership</header><text>The Panel shall be convened and chaired by the Global AIDS Coordinator, who shall serve as a nonvoting member. The Panel shall consist of not more than 15 members (excluding the Global AIDS Coordinator), to be appointed by the Global AIDS Coordinator not later than 1 year after the date of the enactment of this Act, including—</text>
<subparagraph id="HCA05719D3D1E4C1F84BE930E400B834"><enum>(A)</enum><text>2 members from the Department of Health and Human Services with expertise relating to the prevention of mother-to-child transmission activities;</text></subparagraph>
<subparagraph id="H9814931DB7B04608A002535265F054A3"><enum>(B)</enum><text>2 members from the United States Agency for International Development with expertise relating to the prevention of mother-to-child transmission activities;</text></subparagraph>
<subparagraph id="HD74DBB77B8E9459CA3E2CC818ECF5CAF"><enum>(C)</enum><text>2 representatives from among health ministers of national governments of foreign countries in which programs under this Act are administered;</text></subparagraph>
<subparagraph id="H56781BAECC724550B3856DE2960032CC"><enum>(D)</enum><text>3 members representing organizations implementing prevention of mother-to-child transmission activities under this Act;</text></subparagraph>
<subparagraph id="H23155019FB54496D9478077192B4C5BE"><enum>(E)</enum><text>2 health care researchers with expertise relating to global HIV/AIDS activities; and</text></subparagraph>
<subparagraph id="HE506FE5906804573AC00322B37714EFC"><enum>(F)</enum><text>representatives from among patient advocate groups, health care professionals, persons living with HIV/AIDS, and non-governmental organizations with expertise relating to the prevention of mother-to-child transmission activities, giving priority to individuals in foreign countries in which programs under this Act are administered.</text></subparagraph></paragraph>
<paragraph id="H5BD64ED47F1F4CC4B9CA32F500008B7C"><enum>(3)</enum><header>Duties of panel</header><text>The Panel shall—</text>
<subparagraph id="HF8E0F2E60727401D8CB198E154EB8274"><enum>(A)</enum><text>assess the effectiveness of current activities in reaching the target described in subsection (b)(1);</text></subparagraph>
<subparagraph id="HE67F7364326D4BBCA461796E68DAE5B1"><enum>(B)</enum><text>review scientific evidence related to the provision of mother-to-child transmission prevention services, including programmatic data and data from clinical trials;</text></subparagraph>
<subparagraph id="H101F3660A2944AD2B41EDA49F5001150"><enum>(C)</enum><text>review and assess ways in which the Office of the United States Global AIDS Coordinator collaborates with international and multilateral entities on efforts to prevent mother-to-child transmission of HIV in affected countries;</text></subparagraph>
<subparagraph id="HF081651E7FF540F6BD1075FBB7DC5C7B"><enum>(D)</enum><text>identify barriers and challenges to increasing access to mother-to-child transmission prevention services and evaluate potential mechanisms to alleviate those barriers and challenges;</text></subparagraph>
<subparagraph id="HE9D5B378514D4CFE8D2E644EBBBBB27"><enum>(E)</enum><text>identify the extent to which stigma has hindered pregnant women from obtaining HIV counseling and testing or returning for results, and provide recommendations to address such stigma and its effects;</text></subparagraph>
<subparagraph id="H5FBDA3BE7C584F4FAADA6423A8AEE475"><enum>(F)</enum><text>identify opportunities to improve linkages between mother-to-child transmission prevention services and care and treatment programs; and</text></subparagraph>
<subparagraph id="H1BA8D4724DB242B1A570D1CE1C18BCFB"><enum>(G)</enum><text>recommend specific activities to facilitate reaching the target described in subsection (b)(1).</text></subparagraph></paragraph>
<paragraph id="HF37751E15EB54C759DF4D5EAB919F1D"><enum>(4)</enum><header>Report</header>
<subparagraph id="H767D8D33BB3544408BC6438985EFDC6F"><enum>(A)</enum><header>In general</header><text>Not later than 1 year after the date on which the Panel is first convened, the Panel shall submit a report containing a detailed statement of the recommendations, findings, and conclusions of the Panel to the appropriate congressional committees.</text></subparagraph>
<subparagraph id="H6E26C2140F2740128D8035EF058B2F99"><enum>(B)</enum><header>Availability</header><text>The report submitted under subparagraph (A) shall be made available to the public.</text></subparagraph>
<subparagraph id="HFA862FFC103142069DADE09D75235EB4"><enum>(C)</enum><header>Consideration by coordinator</header><text>The Coordinator shall—</text>
<clause id="H4662C5B92CBD43ADB7EE753F58E561"><enum>(i)</enum><text>consider any recommendations contained in the report submitted under subparagraph (A); and</text></clause>
<clause id="H4F7737AFBA824A32A0331FDF6EC38712"><enum>(ii)</enum><text>include in the annual report required under section 104A(f) of the Foreign Assistance Act of 1961 a description of the activities conducted in response to the recommendations made by the Panel and an explanation of any recommendations not implemented at the time of the report.</text></clause></subparagraph></paragraph>
<paragraph id="HC6A40CE236504AB18B4C2CF87481E8BF"><enum>(5)</enum><header>Authorization of appropriations</header><text>There are authorized to be appropriated to the Panel such sums as may be necessary for each of the fiscal years 2009 through 2011 to carry out this section.</text></paragraph>
<paragraph id="HC3240D5E10BD4E64894D6500BCB101F7"><enum>(6)</enum><header>Termination</header><text>The Panel shall terminate on the date that is 60 days after the date on which the Panel submits the report to the appropriate congressional committees under paragraph (4).</text></paragraph></subsection><after-quoted-block>.</after-quoted-block></quoted-block></section></subtitle>
<enum>IV</enum><header>Funding allocations</header>
<section id="H4D7F382FC35C4801A977A8CCEF16187"><enum>401.</enum><header>Authorization of appropriations</header>
<subsection id="H15B1E31C681E47CAB3688DC86A2B136"><enum>(a)</enum><header>In general</header><text display-inline="yes-display-inline">Section 401(a) of the <short-title>United States Leadership Against HIV/AIDS, Tuberculosis, and Malaria Act of 2003</short-title> (<external-xref legal-doc="usc" parsable-cite="usc/22/7671">22 U.S.C. 7671(a)</external-xref>) is amended by striking <quote>$3,000,000,000 for each of the fiscal years 2004 through 2008</quote> and inserting <quote>$48,000,000,000 for the 5-year period beginning on October 1, 2008</quote>.</text></subsection>
<subsection id="HFF6C36FB9C4F4A58AF537818C2661EF0"><enum>(b)</enum><header>Sense of Congress</header><text>It is the sense of the Congress that the appropriations authorized under section 401(a) of the United States Leadership Against HIV/AIDS, Tuberculosis, and Malaria Act of 2003, as amended by subsection (a), should be allocated among fiscal years 2009 through 2013 in a manner that allows for the appropriations to be gradually increased in a manner that is consistent with program requirements, absorptive capacity, and priorities set forth in such Act, as amended by this Act.</text></subsection></section>
<section id="H23456BBE16C947D9A6B000FB8ECA96F3"><enum>402.</enum><header>Sense of Congress</header><text display-inline="no-display-inline">Section 402(b) of the <short-title>United States Leadership Against HIV/AIDS, Tuberculosis, and Malaria Act of 2003</short-title> (<external-xref legal-doc="usc" parsable-cite="usc/22/7672">22 U.S.C. 7672(b)</external-xref>) is amended by striking <quote>an effective distribution of such amounts would be</quote> and all that follows through <quote>10 percent of such amounts</quote> and inserting <quote>10 percent should be used</quote>.</text></section>
<section id="H20B912B2AB6143C19F829828ECD9CD43"><enum>403.</enum><header>Allocation of funds</header><text display-inline="no-display-inline">Section 403 of the <short-title>United States Leadership Against HIV/AIDS, Tuberculosis, and Malaria Act of 2003</short-title> (<external-xref legal-doc="usc" parsable-cite="usc/22/7673">22 U.S.C. 7673</external-xref>) is amended—</text>
<paragraph id="H8E1F6C10A0A24DE4828F06CB3000EAF8"><enum>(1)</enum><text display-inline="yes-display-inline">by amending subsection (a) to read as follows:</text>
<quoted-block display-inline="no-display-inline" id="H9B3475A064894702A9EEF74C7E657BA6" style="OLC">
<subsection id="HB61BE4A473A14074A5D178D2764EEBD5"><enum>(a)</enum><header>Balanced funding requirement</header>
<paragraph id="H844EA70A637B4EDFAA09DFBFDA69DA86"><enum>(1)</enum><header>In general</header><text>The Global AIDS Coordinator shall—</text>
<subparagraph id="H3F549E8C85AE44CABFFFE9D6E3E91D50"><enum>(A)</enum><text>provide balanced funding for prevention activities for sexual transmission of HIV/AIDS; and</text></subparagraph>
<subparagraph id="H03F17587EF05465994189492F12BDC13"><enum>(B)</enum><text>ensure that activities promoting abstinence, delay of sexual debut, monogamy, fidelity, and partner reduction are implemented and funded in a meaningful and equitable way in the strategy for each host country based on objective epidemiological evidence as to the source of infections and in consultation with the government of each host county involved in HIV/AIDS prevention activities.</text></subparagraph></paragraph>
<paragraph id="H08B07050F5E64F6FB400BF00F51D7D24"><enum>(2)</enum><header>Prevention strategy</header>
<subparagraph id="HBA738BAFE2984DADB3702EB29D60BCA3"><enum>(A)</enum><header>Establishment</header><text>In carrying out paragraph (1), the Global AIDS Coordinator shall establish an HIV sexual transmission prevention strategy governing the expenditure of funds authorized under this Act to prevent the sexual transmission of HIV in any host country with a generalized epidemic.</text></subparagraph>
<subparagraph id="H5C796A8D89B54FF10053ECD1A6BDF16E"><enum>(B)</enum><header>Report</header><text>In each host country described in subparagraph (A), if the strategy established under subparagraph (A) provides less than 50 percent of the funds described in subparagraph (A) for activities promoting abstinence, delay of sexual debut, monogamy, fidelity, and partner reduction, the Global AIDS Coordinator shall, not later than 30 days after the issuance of this strategy, report to the appropriate congressional committees on the justification for this decision.</text></subparagraph></paragraph>
<paragraph id="HC0FCDBE04EC5489FB2009FA53850AC02"><enum>(3)</enum><header>Exclusion</header><text>Programs and activities that implement or purchase new prevention technologies or modalities, such as medical male circumcision, public education about risks to acquire HIV infection from blood exposures, promoting universal precautions, investigating suspected nosocomial infections, pre-exposure pharmaceutical prophylaxis to prevent transmission of HIV, or microbicides and programs and activities that provide counseling and testing for HIV or prevent mother-to-child prevention of HIV, shall not be included in determining compliance with paragraph (2).</text></paragraph>
<paragraph commented="no" display-inline="no-display-inline" id="H8A2A2C315CA74C88932CD57F6464424F"><enum>(4)</enum><header>Report</header><text>Not later than 1 year after the date of the enactment of the <short-title>Tom Lantos and Henry J. Hyde United States Global Leadership Against HIV/AIDS, Tuberculosis, and Malaria Reauthorization Act of 2008</short-title>, and annually thereafter as part of the annual report required under section 104A(e) of the Foreign Assistance Act of 1961 (<external-xref legal-doc="usc" parsable-cite="usc/22/2151b-2">22 U.S.C. 2151b–2(e)</external-xref>), the President shall—</text>
<subparagraph commented="no" display-inline="no-display-inline" id="HBDA241D1EE8B4A01B82FB200F1ACDBDC"><enum>(A)</enum><text>submit a report on the implementation of paragraph (2) for the most recently concluded fiscal year to the appropriate congressional committees; and</text></subparagraph>
<subparagraph commented="no" display-inline="no-display-inline" id="H5B3DE5C23F524841AE297267C00EBAA"><enum>(B)</enum><text>make the report described in subparagraph (A) available to the public.</text></subparagraph></paragraph></subsection><after-quoted-block>;</after-quoted-block></quoted-block></paragraph>
<paragraph id="HCE4D79E85B65414899004658756F2B00"><enum>(2)</enum><text display-inline="yes-display-inline">in subsection (b)—</text>
<subparagraph id="HA6EA07E58CBA4DDF85238B558833D6AA"><enum>(A)</enum><text display-inline="yes-display-inline">by striking <quote>fiscal years 2006 through 2008</quote> and inserting <quote>fiscal years 2009 through 2013</quote>; and</text></subparagraph>
<subparagraph id="H972C2D8E3D114DC889121D157C425F00"><enum>(B)</enum><text>by striking <quote>vulnerable children affected by</quote> and inserting <quote>other children affected by, or vulnerable to,</quote>; and</text></subparagraph></paragraph>
<paragraph id="H4734FB54F5AE4D07A7305326EBAB838E"><enum>(3)</enum><text>by adding at the end the following:</text>
<quoted-block display-inline="no-display-inline" id="H31296F25B3BA49CA9C00E1253F366DAD" style="OLC">
<subsection id="H0B220633BDED44F9BA9C9DE21072A1C"><enum>(c)</enum><header>Funding allocation</header><text>For each of the fiscal years 2009 through 2013, more than half of the amounts appropriated for bilateral global HIV/AIDS assistance pursuant to section 401 shall be expended for—</text>
<paragraph id="H8B767CA43C524DCF8F0019EE7B46CD00"><enum>(1)</enum><text>antiretroviral treatment for HIV/AIDS;</text></paragraph>
<paragraph id="H8CE81B9257F44BCEA15CC8619BEF0072"><enum>(2)</enum><text>clinical monitoring of HIV-seropositive people not in need of antiretroviral treatment;</text></paragraph>
<paragraph id="HAA54494DDAA8471A9BD7B29370A83FCF"><enum>(3)</enum><text>care for associated opportunistic infections;</text></paragraph>
<paragraph id="H6289EA2F075543B480EC305D51817162"><enum>(4)</enum><text>nutrition and food support for people living with HIV/AIDS; and</text></paragraph>
<paragraph id="H9201C112A90D490C8FE3141C56D40017"><enum>(5)</enum><text>other essential HIV/AIDS-related medical care for people living with HIV/AIDS.</text></paragraph></subsection>
<subsection id="HA628D83A38D849619EC7BDC7F628AEA2"><enum>(d)</enum><header>Treatment, prevention, and care goals</header><text>For each of the fiscal years 2009 through 2013—</text>
<paragraph id="H6D719920EB2F4D7300156D72DBA55F00"><enum>(1)</enum><text>the treatment goal under section 402(a)(3) shall be increased above 2,000,000 by at least the percentage increase in the amount appropriated for bilateral global HIV/AIDS assistance for such fiscal year compared with fiscal year 2008;</text></paragraph>
<paragraph id="H419CFC26A7CC4877947865368E8798E4"><enum>(2)</enum><text>any increase in the treatment goal under section 402(a)(3) above the percentage increase in the amount appropriated for bilateral global HIV/AIDS assistance for such fiscal year compared with fiscal year 2008 shall be based on long-term requirements, epidemiological evidence, the share of treatment needs being met by partner governments and other sources of treatment funding, and other appropriate factors;</text></paragraph>
<paragraph id="HB926B6AFD88E461CA72963AD0297BA46"><enum>(3)</enum><text>the treatment goal under section 402(a)(3) shall be increased above the number calculated under paragraph (1) by the same percentage that the average United States Government cost per patient of providing treatment in countries receiving bilateral HIV/AIDS assistance has decreased compared with fiscal year 2008; and</text></paragraph>
<paragraph id="H60DE78917400442F958DD5DFEDCFD3C1"><enum>(4)</enum><text>the prevention and care goals established in clauses (i) and (iv) of section 104A(b)(1)(A) of the Foreign Assistance Act of 1961 (<external-xref legal-doc="usc" parsable-cite="usc/22/2151b-2">22 U.S.C. 2151b–2(b)(1)(A)</external-xref>) shall be increased consistent with epidemiological evidence and available resources.</text></paragraph></subsection><after-quoted-block>.</after-quoted-block></quoted-block></paragraph></section>
<enum>V</enum><header>Miscellaneous</header>
<section id="H9CB5AE35CB37471BAA7BEFCC30E924D3"><enum>501.</enum><header>Machine readable visa fees</header>
<subsection id="H850553B1F3C7401EBFB5D072C96600A1"><enum>(a)</enum><header>Fee increase</header><text>Notwithstanding any other provision of law—</text>
<paragraph id="HEB7A5553F7514ED7B6E753776D29364E"><enum>(1)</enum><text>not later than October 1, 2010, the Secretary of State shall increase by $1 the fee or surcharge authorized under section 140(a) of the Foreign Relations Authorization Act, Fiscal Years 1994 and 1995 (<external-xref legal-doc="public-law" parsable-cite="pl/103/236">Public Law 103–236</external-xref>; <external-xref legal-doc="usc" parsable-cite="usc/8/1351">8 U.S.C. 1351</external-xref> note) for processing machine readable nonimmigrant visas and machine readable combined border crossing identification cards and nonimmigrant visas; and</text></paragraph>
<paragraph id="HE3EA0FA9E875429AB011E2AFD68A7F7"><enum>(2)</enum><text>not later than October 1, 2013, the Secretary shall increase the fee or surcharge described in paragraph (1) by an additional $1.</text></paragraph></subsection>
<subsection id="H47031583B97A4AC286587300DE74EC54"><enum>(b)</enum><header>Deposit of amounts</header><text>Notwithstanding section 140(a)(2) of the Foreign Relations Authorization Act, Fiscal Years 1994 and 1995 (<external-xref legal-doc="public-law" parsable-cite="pl/103/236">Public Law 103–236</external-xref>; <external-xref legal-doc="usc" parsable-cite="usc/8/1351">8 U.S.C. 1351</external-xref> note), fees collected under the authority of subsection (a) shall be deposited in the Treasury.</text></subsection></section>
<enum>VI</enum><header>Emergency plan for Indian safety and health</header>
<section id="H6B4245B8F34E4EE3B4DDFEC4ACA3728C"><enum>601.</enum><header>Emergency plan for Indian safety and health</header>
<subsection id="HEB47CD361F3A477C9F84E5D26396843"><enum>(a)</enum><header>Establishment of Fund</header><text>There is established in the Treasury of the United States a fund, to be known as the <quote>Emergency Fund for Indian Safety and Health</quote> (referred to in this section as the <quote>Fund</quote>), consisting of such amounts as are appropriated to the Fund under subsection (b).</text></subsection>
<subsection id="H8A4813EA33C2429DA5A759E8DBA007D"><enum>(b)</enum><header>Transfers to Fund</header>
<paragraph id="HD19E2F0CABB74DECBD9870F6F596D92D"><enum>(1)</enum><header>In general</header><text>There is authorized to be appropriated to the Fund, out of funds of the Treasury not otherwise appropriated, $2,000,000,000 for the 5-year period beginning on October 1, 2008.</text></paragraph>
<paragraph id="HC19066A5DFB34E9100767C013F9DA042"><enum>(2)</enum><header>Availability of amounts</header><text>Amounts deposited in the Fund under this section shall—</text>
<subparagraph id="H1EA4104719C1471BBFDFAEBA239FBFAF"><enum>(A)</enum><text>be made available without further appropriation;</text></subparagraph>
<subparagraph id="H9BEFC63882964DCA8770986609C0C7FE"><enum>(B)</enum><text>be in addition to amounts made available under any other provision of law; and</text></subparagraph>
<subparagraph id="H48215F35AF534EB98BAFE6D6E2EEE53D"><enum>(C)</enum><text>remain available until expended.</text></subparagraph></paragraph></subsection>
<subsection id="HC00BFAE1BEFD430F0062F7ADC681ADD3"><enum>(c)</enum><header>Expenditures from Fund</header><text>On request by the Attorney General, the Secretary of the Interior, or the Secretary of Health and Human Services, the Secretary of the Treasury shall transfer from the Fund to the Attorney General, the Secretary of the Interior, or the Secretary of Health and Human Services, as appropriate, such amounts as the Attorney General, the Secretary of the Interior, or the Secretary of Health and Human Services determines to be necessary to carry out the emergency plan under subsection (f).</text></subsection>
<subsection id="HD9DC1E2DC2844931838DBF8E6E00411B"><enum>(d)</enum><header>Transfers of amounts</header>
<paragraph id="H7BA7A0C89739432FAFDFABCCDE7216"><enum>(1)</enum><header>In general</header><text>The amounts required to be transferred to the Fund under this section shall be transferred at least monthly from the general fund of the Treasury to the Fund on the basis of estimates made by the Secretary of the Treasury.</text></paragraph>
<paragraph commented="no" display-inline="no-display-inline" id="H5B8F13DCA7954C1281D65715F30678B3"><enum>(2)</enum><header>Adjustments</header><text>Proper adjustment shall be made in amounts subsequently transferred to the extent prior estimates were in excess of or less than the amounts required to be transferred.</text></paragraph></subsection>
<subsection commented="no" display-inline="no-display-inline" id="HBBFA2DB0D5624F58B3E14B9F7DA68ED5"><enum>(e)</enum><header>Remaining amounts</header><text>Any amounts remaining in the Fund on September 30 of an applicable fiscal year may be used by the Attorney General, the Secretary of the Interior, or the Secretary of Health and Human Services to carry out the emergency plan under subsection (f) for any subsequent fiscal year.</text></subsection>
<subsection id="H752DC93F27A04DDA83C83858F46731B0"><enum>(f)</enum><header>Emergency plan</header><text>Not later than 1 year after the date of enactment of this Act, the Attorney General, the Secretary of the Interior, and the Secretary of Health and Human Services, in consultation with Indian tribes (as defined in section 4 of the <act-name parsable-cite="ISDA">Indian Self-Determination and Education Assistance Act</act-name> (<external-xref legal-doc="usc" parsable-cite="usc/25/450b">25 U.S.C. 450b</external-xref>)), shall jointly establish an emergency plan that addresses law enforcement, water, and health care needs of Indian tribes under which, for each of fiscal years 2010 through 2019, of amounts in the Fund—</text>
<paragraph id="HD8D300DCF51849218BCB4F87F0AEC6EE"><enum>(1)</enum><text>the Attorney General shall use—</text>
<subparagraph id="HEE98A8B724A14A738E51B3270066BB89"><enum>(A)</enum><text>18.5 percent for the construction, rehabilitation, and replacement of Federal Indian detention facilities;</text></subparagraph>
<subparagraph id="H79243FA5A8334722B36403A120E4002E"><enum>(B)</enum><text>1.5 percent to investigate and prosecute crimes in Indian country (as defined in <external-xref legal-doc="usc" parsable-cite="usc/18/1151">section 1151</external-xref> of title 18, United States Code);</text></subparagraph>
<subparagraph id="HA98DD480D65641E19113AA4E88EA38E7"><enum>(C)</enum><text>1.5 percent for use by the Office of Justice Programs for Indian and Alaska Native programs; and</text></subparagraph>
<subparagraph id="H05247C6F4A204D8BADAE00CFF7E372C3"><enum>(D)</enum><text>0.5 percent to provide assistance to—</text>
<clause id="H8EEF59C3B5F940ECB0D19910002C719C"><enum>(i)</enum><text>parties to cross-deputization or other cooperative agreements between State or local governments and Indian tribes (as defined in section 102 of the Federally Recognized Indian Tribe List Act of 1994 (<external-xref legal-doc="usc" parsable-cite="usc/25/479a">25 U.S.C. 479a</external-xref>)) carrying out law enforcement activities in Indian country; and</text></clause>
<clause id="H99DF932CF4B74C54B65EBDA6024E100"><enum>(ii)</enum><text>the State of Alaska (including political subdivisions of that State) for carrying out the Village Public Safety Officer Program and law enforcement activities on Alaska Native land (as defined in section 3 of <external-xref legal-doc="public-law" parsable-cite="pl/103/399">Public Law 103–399</external-xref> (<external-xref legal-doc="usc" parsable-cite="usc/25/3902">25 U.S.C. 3902</external-xref>));</text></clause></subparagraph></paragraph>
<paragraph id="HE3DBB29129134F61865FDE972BCCE8C"><enum>(2)</enum><text>the Secretary of the Interior shall—</text>
<subparagraph id="H838E0FC7BC994319B4BB45298D49E817"><enum>(A)</enum><text>deposit 15.5 percent in the public safety and justice account of the Bureau of Indian Affairs for use by the Office of Justice Services of the Bureau in providing law enforcement or detention services, directly or through contracts or compacts with Indian tribes under the Indian Self-Determination and Education Assistance Act (<external-xref legal-doc="usc" parsable-cite="usc/25/450">25 U.S.C. 450 et seq.</external-xref>); and</text></subparagraph>
<subparagraph id="HCAA9BE7DD59B442D9BF2622B03C6A239"><enum>(B)</enum><text>use 50 percent to implement requirements of Indian water settlement agreements that are approved by Congress (or the legislation to implement such an agreement) under which the United States shall plan, design, rehabilitate, or construct, or provide financial assistance for the planning, design, rehabilitation, or construction of, water supply or delivery infrastructure that will serve an Indian tribe (as defined in section 4 of the <act-name parsable-cite="ISDA">Indian Self-Determination and Education Assistance Act</act-name> (<external-xref legal-doc="usc" parsable-cite="usc/25/450b">25 U.S.C. 450b</external-xref>)); and</text></subparagraph></paragraph>
<paragraph id="H5122CBD298D3436FACBFB1867D000964"><enum>(3)</enum><text>the Secretary of Health and Human Services, acting through the Director of the Indian Health Service, shall use 12.5 percent to provide, directly or through contracts or compacts with Indian tribes under the Indian Self-Determination and Education Assistance Act (<external-xref legal-doc="usc" parsable-cite="usc/25/450">25 U.S.C. 450 et seq.</external-xref>)—</text>
<subparagraph id="H47E6D177DF9B40F0941FD4133FE9D56F"><enum>(A)</enum><text>contract health services;</text></subparagraph>
<subparagraph commented="no" display-inline="no-display-inline" id="HDFDBD693740B41C8A07D00A0712D06A3"><enum>(B)</enum><text display-inline="yes-display-inline">construction, rehabilitation, and replacement of Indian health facilities; and</text></subparagraph>
<subparagraph id="H535D887C8084444FA63D819F6DC3CCAB"><enum>(C)</enum><text>domestic and community sanitation facilities serving members of Indian tribes (as defined in section 4 of the <act-name parsable-cite="ISDA">Indian Self-Determination and Education Assistance Act</act-name> (<external-xref legal-doc="usc" parsable-cite="usc/25/450b">25 U.S.C. 450b</external-xref>)) pursuant to section 7 of the Act of August 5, 1954 (<external-xref legal-doc="usc" parsable-cite="usc/42/2004a">42 U.S.C. 2004a</external-xref>).</text></subparagraph></paragraph></subsection></section>
Speaker of the House of Representatives.Vice President of the United States and President of the Senate.