[Congressional Bills 113th Congress]
[From the U.S. Government Publishing Office]
[S. 1545 Enrolled Bill (ENR)]
S.1545
One Hundred Thirteenth Congress
of the
United States of America
AT THE FIRST SESSION
Begun and held at the City of Washington on Thursday,
the third day of January, two thousand and thirteen
An Act
To extend authorities related to global HIV/AIDS and to promote
oversight of United States programs.
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the ``PEPFAR Stewardship and Oversight Act
of 2013''.
SEC. 2. INSPECTOR GENERAL OVERSIGHT.
Section 101(f)(1) of the United States Leadership Against HIV/AIDS,
Tuberculosis, and Malaria Act of 2003 (22 U.S.C. 7611(f)(1)) is
amended--
(1) in subparagraph (A), by striking ``5 coordinated annual
plans for oversight activity in each of the fiscal years 2009
through 2013'' and inserting ``coordinated annual plans for
oversight activity in each of the fiscal years 2009 through 2018'';
and
(2) in subparagraph (C)--
(A) in clause (ii)--
(i) in the heading, by striking ``Subsequent'' and
inserting ``2010 through 2013''; and
(ii) by striking ``the last four plans'' and inserting
``the plans for fiscal years 2010 through 2013''; and
(B) by adding at the end the following new clause:
``(iii) 2014 plan.--The plan developed under
subparagraph (A) for fiscal year 2014 shall be completed
not later than 60 days after the date of the enactment of
the PEPFAR Stewardship and Oversight Act of 2013.
``(iv) Subsequent plans.--Each of the last four plans
developed under subparagraph (A) shall be completed not
later than 30 days before each of the fiscal years 2015
through 2018, respectively.''.
SEC. 3. ANNUAL TREATMENT STUDY.
(a) Annual Study; Message.--Section 101(g) of the United States
Leadership Against HIV/AIDS, Tuberculosis, and Malaria Act of 2003 (22
U.S.C. 7611(g)) is amended--
(1) in paragraph (1), by striking ``through September 30,
2013'' and inserting ``through September 30, 2019'';
(2) by redesignating paragraph (2) as paragraph (3);
(3) by inserting after paragraph (1) the following new
paragraph:
``(2) 2013 through 2018 studies.--The studies required to be
submitted by September 30, 2014, and annually thereafter through
September 30, 2018, shall include, in addition to the elements set
forth under paragraph (1), the following elements:
``(A) A plan for conducting cost studies of United States
assistance under section 104A of the Foreign Assistance Act of
1961 (22 U.S.C. 2151b-2) in partner countries, taking into
account the goal for more systematic collection of data, as
well as the demands of such analysis on available human and
fiscal resources.
``(B) A comprehensive and harmonized expenditure analysis
by partner country, including--
``(i) an analysis of Global Fund and national partner
spending and comparable data across United States, Global
Fund, and national partner spending; or
``(ii) where providing such comparable data is not
currently practicable, an explanation of why it is not
currently practicable, and when it will be practicable.'';
and
(4) by adding at the end the following new paragraph:
``(4) Partner country defined.--In this subsection, the term
`partner country' means a country with a minimum United States
Government investment of HIV/AIDS assistance of at least $5,000,000
in the prior fiscal year.''.
SEC. 4. PARTICIPATION IN THE GLOBAL FUND TO FIGHT AIDS, TUBERCULOSIS,
AND MALARIA.
(a) Limitation.--Section 202(d)(4) of the United States Leadership
Against HIV/AIDS, Tuberculosis, and Malaria Act of 2003 (22 U.S.C.
7622(d)(4)) is amended--
(1) in subparagraph (A)--
(A) in clause (i), by striking ``2013'' and inserting
``2018'';
(B) in clause (ii)--
(i) by striking ``2013'' and inserting ``2018''; and
(ii) by striking the last two sentences; and
(C) in clause (vi), by striking ``2013'' and inserting
``2018''; and
(2) in subparagraph (B)--
(A) by striking ``under this subsection'' each place it
appears;
(B) in clause (ii), by striking ``pursuant to the
authorization of appropriations under section 401'' and
inserting ``to carry out section 104A of the Foreign Assistance
Act of 1961''; and
(C) in clause (iv), by striking ``2013'' and inserting
``2018''.
(b) Withholding Funds.--Section 202(d)(5) of the United States
Leadership Against HIV/AIDS, Tuberculosis, and Malaria Act of 2003 (22
U.S.C. 7622(d)) is amended by--
(1) in paragraph (5)--
(A) by striking ``2013'' and inserting ``2018'';
(B) in subparagraph (C)--
(i) by inserting ``in an open, machine readable
format'' after ``site'';
(ii) by amending clause (v) to read as follows:
``(v) a regular collection, analysis, and reporting of
performance data and funding of grants of the Global Fund,
which covers all principal recipients and all subrecipients
on the fiscal cycle of each grant, and includes the
distribution of resources, by grant and principal recipient
and subrecipient, for prevention, care, treatment, drugs,
and commodities purchase, and other purposes as
practicable;'';
(C) in subparagraph (D)(ii), by inserting ``, in an open,
machine readable format,'' after ``audits'';
(D) in subparagraph (E), by inserting ``, in an open,
machine readable format,'' after ``publicly'';
(E) in subparagraph (F)--
(i) in clause (i), by striking ``; and'' and inserting
a semicolon; and
(ii) by striking clause (ii) and inserting the
following new clauses:
``(ii) all principal recipients and subrecipients and
the amount of funds disbursed to each principal recipient
and subrecipient on the fiscal cycle of the grant;
``(iii) expenditure data--
``(I) tracked by principal recipients and
subrecipients by program area, where practicable,
prevention, care, and treatment and reported in a
format that allows comparison with other funding
streams in each country; or
``(II) if such expenditure data is not available,
outlay or disbursement data, and an explanation of
progress made toward providing such expenditure data;
and
``(iv) high-quality grant performance evaluations
measuring inputs, outputs, and outcomes, as appropriate,
with the goal of achieving outcome reporting;''; and
(F) by amending subparagraph (G) to read as follows:
``(G) has published an annual report on a publicly
available Web site in an open, machine readable format, that
includes--
``(i) a list of all countries imposing import duties
and internal taxes on any goods or services financed by the
Global Fund;
``(ii) a description of the types of goods or services
on which the import duties and internal taxes are levied;
``(iii) the total cost of the import duties and
internal taxes;
``(iv) recovered import duties or internal taxes; and
``(v) the status of country status-agreements;''.
SEC. 5. ANNUAL REPORT.
Section 104A(f) of the Foreign Assistance Act of 1961 (22 U.S.C.
2151b-2(f)) is amended to read as follows:
``(f) Annual Report.--
``(1) In general.--Not later than February 15, 2014, and
annually thereafter, the President shall submit to the Committee on
Foreign Relations of the Senate and the Committee on Foreign
Affairs of the House of Representatives a report in an open,
machine readable format, on the implementation of this section for
the prior fiscal year.
``(2) Report due in 2014.--The report due not later than
February 15, 2014, shall include the elements required by law prior
to the enactment of the PEPFAR Stewardship and Oversight Act of
2013.
``(3) Report elements.--Each report submitted after February
15, 2014, shall include the following:
``(A) A description based on internationally available
data, and where practicable high-quality country-based data, of
the total global burden and need for HIV/AIDS prevention,
treatment, and care, including--
``(i) estimates by partner country of the global burden
and need; and
``(ii) HIV incidence, prevalence, and AIDS deaths for
the reporting period.
``(B) Reporting on annual targets across prevention,
treatment, and care interventions in partner countries,
including--
``(i) a description of how those targets are designed
to--
``(I) ensure that the annual increase in new
patients on antiretroviral treatment exceeds the number
of annual new HIV infections;
``(II) reduce the number of new HIV infections
below the number of deaths among persons infected with
HIV; and
``(III) achieve an AIDS-free generation;
``(ii) national targets across prevention, treatment,
and care that are--
``(I) established by partner countries; or
``(II) where such national partner country-
developed targets are unavailable, a description of
progress towards developing national partner country
targets; and
``(iii) bilateral programmatic targets across
prevention, treatment, and care, including--
``(I) the number of adults and children to be
directly supported on HIV treatment under United
States-funded programs;
``(II) the number of adults and children to be
otherwise supported on HIV treatment under United
States-funded programs; and
``(III) other programmatic targets for activities
directly and otherwise supported by United States-
funded programs.
``(C) A description, by partner country, of HIV/AIDS
funding from all sources, including funding levels from partner
countries, other donors, and the private sector, as
practicable.
``(D) A description of how United States-funded programs,
in conjunction with the Global Fund, other donors, and partner
countries, together set targets, measure progress, and achieve
positive outcomes in partner countries.
``(E) An annual assessment of outcome indicator
development, dissemination, and performance for programs
supported under this section, including ongoing corrective
actions to improve reporting.
``(F) A description and explanation of changes in related
guidance or policies related to implementation of programs
supported under this section.
``(G) An assessment and quantification of progress over the
reporting period toward achieving the targets set forth in
subparagraph (B), including--
``(i) the number, by partner country, of persons on HIV
treatment, including specifically--
``(I) the number of adults and children on HIV
treatment directly supported by United States-funded
programs; and
``(II) the number of adults and children on HIV
treatment otherwise supported by United States-funded
programs;
``(ii) HIV treatment coverage rates by partner country;
``(iii) the net increase in persons on HIV treatment by
partner country;
``(iv) new infections of HIV by partner country;
``(v) the number of HIV infections averted;
``(vi) antiretroviral treatment program retention rates
by partner country, including--
``(I) performance against annual targets for
program retention; and
``(II) the retention rate of persons on HIV
treatment directly supported by United States-funded
programs; and
``(vii) a description of supportive care.
``(H) A description of partner country and United States-
funded HIV/AIDS prevention programs and policies, including--
``(i) an assessment by country of progress towards
targets set forth in subparagraph (B), with a detailed
description of the metrics used to assess--
``(I) programs to prevent mother to child
transmission of HIV/AIDS, including coverage rates;
``(II) programs to provide or promote voluntary
medical male circumcision, including coverage rates;
``(III) programs for behavior-change; and
``(IV) other programmatic activities to prevent the
transmission of HIV;
``(ii) antiretroviral treatment as prevention; and
``(iii) a description of any new preventative
interventions or methodologies.
``(I) A description of the goals, scope, and measurement of
program efforts aimed at women and girls.
``(J) A description of the goals, scope, and measurement of
program efforts aimed at orphans, vulnerable children, and
youth.
``(K) A description of the indicators and milestones used
to assess effective, strategic, and appropriately timed country
ownership, including--
``(i) an explanation of the metrics used to determine
whether the pace of any transition to such ownership is
appropriate for that country, given that country's level of
readiness for such transition;
``(ii) an analysis of governmental and local
nongovernmental capacity to sustain positive outcomes;
``(iii) a description of measures taken to improve
partner country capacity to sustain positive outcomes where
needed; and
``(iv) for countries undergoing a transition to greater
country ownership, a description of strategies to assess
and mitigate programmatic and financial risk and to ensure
continued quality of care for essential services.
``(L) A description, globally and by partner country, of
specific efforts to achieve and incentivize greater
programmatic and cost effectiveness, including--
``(i) progress toward establishing common economic
metrics across prevention, care and treatment with partner
countries and the Global Fund;
``(ii) average costs, by country and by core
intervention;
``(iii) expenditure reporting in all program areas,
supplemented with targeted analyses of the cost-
effectiveness of specific interventions; and
``(iv) import duties and internal taxes imposed on
program commodities and services, by country.
``(M) A description of partnership framework agreements
with countries, and regions where applicable, including--
``(i) the objectives and structure of partnership
framework agreements with countries, including--
``(I) how these agreements are aligned with
national HIV/AIDS plans and public health strategies
and commitments of such countries; and
``(II) how these agreements incorporate a role for
civil society; and
``(ii) a description of what has been learned in
advancing partnership framework agreements with countries,
and regions as applicable, in terms of improved
coordination and collaboration, definition of clear roles
and responsibilities of participants and signers, and
implications for how to further strengthen these agreements
with mutually accountable measures of progress.
``(N) A description of efforts and activities to engage new
partners, including faith-based, locally-based, and United
States minority-serving institutions.
``(O) A definition and description of the differentiation
between directly and otherwise supported activities, including
specific efforts to clarify programmatic attribution and
contribution, as well as timelines for dissemination and
implementation.
``(P) A description, globally and by country, of specific
efforts to address co-infections and co-morbidities of HIV/
AIDS, including--
``(i) the number and percent of people in HIV care or
treatment who started tuberculosis treatment; and
``(ii) the number and percentage of eligible HIV
positive patients starting isoniazid preventative therapy.
``(Q) A description of efforts by partner countries to
train, employ, and retain health care workers, including
efforts to address workforce shortages.
``(R) A description of program evaluations completed during
the reporting period, including whether all completed
evaluations have been published on a publically available
Internet website and whether any completed evaluations did not
adhere to the common evaluation standards of practice published
under paragraph (4).
``(4) Common evaluation standards.--Not later than February 1,
2014, the Global AIDS Coordinator shall publish on a publically
available Internet website the common evaluation standards of
practice referred to in paragraph (3)(R).
``(5) Partner country defined.--In this subsection, the term
`partner country' means a country with a minimum United States
Government investment of HIV/AIDS assistance of at least $5,000,000
in the prior fiscal year.''.
SEC. 6. ALLOCATION OF FUNDING.
(a) Orphans and Vulnerable Children.--Section 403(b) of the United
States Leadership Against HIV/AIDS, Tuberculosis, and Malaria Act of
2003 (22 U.S.C. 7673(b)) is amended--
(1) by striking ``2013'' and inserting ``2018''; and
(2) by striking ``amounts appropriated pursuant to the
authorization of appropriations under section 401'' and inserting
``amounts appropriated or otherwise made available to carry out the
provisions of section 104A of the Foreign Assistance Act of 1961
(22 U.S.C. 2151b-2)''.
(b) Funding Allocation.--Section 403(c) of the United States
Leadership Against HIV/AIDS, Tuberculosis, and Malaria Act of 2003 (22
U.S.C. 7673(c)) is amended--
(1) by striking ``2013'' and inserting ``2018''; and
(2) by striking ``amounts appropriated for bilateral global
HIV/AIDS assistance pursuant to section 401'' and inserting
``amounts appropriated or otherwise made available to carry out the
provisions of section 104A of the Foreign Assistance Act of 1961
(22 U.S.C. 2151b-2)''.
Speaker of the House of Representatives.
Vice President of the United States and
President of the Senate.