II 110th CONGRESS 2d Session S. 2749 IN THE SENATE OF THE UNITED STATES March 12, 2008 Mr. Coburn (for himself, Mr. Burr, and Mr. Kyl) introduced the following bill; which was read twice and referred to the Committee on Foreign Relations A BILL To ensure that the highest priority for HIV/AIDS-related funding is saving lives most immediately and urgently threatened by HIV–AIDS, including babies at risk of being infected at birth.

1.

Short title

This Act may be cited as the Save Lives First Act of 2008.

2.

Findings

Congress makes the following findings: (1)According to the United Nations, there were— (A)33,200,000 people living with HIV/AIDS worldwide in 2007, including 22,500,000 people in sub-Saharan Africa; (B)2,500,000 new HIV/AIDS infections in 2007, including 1,700,000 in sub-Saharan Africa; and (C)2,010,000 people on antiretroviral therapy in developing countries in 2006. (2)Over 2,100,000 people die from AIDS every year. (3)Fewer than 10 percent of HIV-infected individuals in the developing world receive treatment. (4)More than 80 percent of people with HIV/AIDS in developing countries are unaware of their status. (5)Peer-reviewed studies have shown that patients who are well managed on anti-retroviral therapy achieve low viral loads, which may reduce their chances of infecting others. (6)Perinatal transmission is the leading cause of pediatric HIV infections, despite medical advances that have made it possible to nearly eliminate perinatal HIV transmission. (7)Research studies have demonstrated that the administration of antiretroviral medication during pregnancy, during labor, and immediately following birth can significantly reduce the transmission of HIV from an infected mother to her baby. (8)Nevirapine, an antiretroviral drug that costs less than $4 a dose, has been proven to prevent HIV transmission from mother to child with the administration of just two doses. (9)Even if treatment begins shortly after birth, antiretroviral therapy can substantially reduce the chance that an HIV-exposed infant will become infected. (10)The American Medical Association recommends universal HIV testing of all newborns with appropriate treatment for affected mothers and children. (11)Testing newborns whose mothers' statuses are unknown ensures that every child at risk for HIV is identified. (12)The provision of testing of pregnant women and newborns with appropriate counseling and treatment can significantly reduce the number of pediatric HIV infections, including AIDS cases, improve access to medical care for women and children, and provide opportunities to further reduce transmission among adults. (13)The provision of such testing, counseling, and treatment can reduce the overall cost of pediatric HIV infections, including AIDS cases. (14)Saving lives with HIV/AIDS treatment is the best way to prevent children from becoming orphans and to preserve the family and community structure so essential to social cohesion and economic prosperity in communities affected by AIDS. (15)The provision of HIV/AIDS treatment has brought hope, health, and a future to communities living under a death sentence, and with worldwide death rates still exceeding 2,100,000 per year, other objectives, although meritorious, must defer to testing and treatment.

3.

Allocation of funds for therapeutic medical care

Section 403(a) of the United States Leadership Against HIV/AIDS, Tuberculosis, and Malaria Act of 2003 (22 U.S.C. 7673(a)) is amended by striking (a) Therapeutic medical care.— and all that follows through related care. For fiscal years 2006 through 2008 and inserting the following: “(a) Therapeutic medical care.— (1)

Allocation of HIV assistance funds

(A)

In general

For fiscal years 2009 through 2013— (i)not less than 55 percent of the amounts appropriated pursuant to the authorization of appropriations under section 401 for HIV/AIDS assistance for each such fiscal year shall be expended for therapeutic medical care of individuals infected with HIV, in furtherance of the requirement under subparagraph (B)(i); (ii)not less than 5 percent of the amounts appropriated pursuant to the authorization of appropriations under section 401 for HIV/AIDS assistance for each such fiscal year shall be expended to expand the use of rapid HIV/AIDS testing, in furtherance of the requirement under subparagraph (B)(ii); and (iii)not less than 25 percent of the amount allocated under clause (ii) shall be expended for assistance to countries that have adopted a national policy of universal, routine, rapid HIV/AIDS diagnosis of all patients of publicly funded facilities, including pregnant women and newborns. (B)

Required medical progress

The President shall ensure that, by the end of fiscal year 2013— (i)antiretroviral treatment for HIV/AIDS and associated opportunistic infections or medical monitoring of HIV-seropositive people not in clinical need of retroviral treatment has been provided to no fewer than 7,000,000 people living in countries receiving funding under this Act; (ii)no fewer than 1,000,000,000 rapid tests for HIV/AIDS have been conducted on people living in countries receiving funding under this Act; and (iii)every available intervention is provided to ensure that 100 percent of infants born to HIV-infected women in countries where funds are expended pursuant to this Act are born uninfected and remain uninfected for at least the first year after birth, as measured by 100 percent diagnosis of pregnant women for HIV infection and of newborns for HIV antibodies and 100 percent treatment for each such mother or child diagnosed. (2)

Allocation of HIV/AIDS prevention funds

For fiscal years 2006 through 2008 .