[Congressional Bills 113th Congress]
[From the U.S. Government Publishing Office]
[S. 1545 Reported in Senate (RS)]
Calendar No. 202
113th CONGRESS
1st Session
S. 1545
[Report No. 113-112]
To extend authorities related to global HIV/AIDS and to promote
oversight of United States programs.
_______________________________________________________________________
IN THE SENATE OF THE UNITED STATES
September 24, 2013
Mr. Menendez (for himself and Mr. Corker) introduced the following
bill; which was read twice and referred to the Committee on Foreign
Relations
October 2, 2013
Reported by Mr. Menendez, with amendments
[Omit the part struck through and insert the part printed in italic]
_______________________________________________________________________
A BILL
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 <DELETED>annually</DELETED> 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
<DELETED>by prevention, care, and
treatment as practicable</DELETED> 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.
``<DELETED>(2)</DELETED>(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<DELETED>, including management of co-
morbidities</DELETED>.
``(H) A description of <DELETED>national</DELETED>
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 counties 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,
<DELETED>community-based</DELETED> 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.
``<DELETED>(3)</DELETED>(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 <DELETED>annually</DELETED>
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)''.
Calendar No. 202
113th CONGRESS
1st Session
S. 1545
[Report No. 113-112]
_______________________________________________________________________
A BILL
To extend authorities related to global HIV/AIDS and to promote
oversight of United States programs.
_______________________________________________________________________
October 2, 2013
Reported with amendments