[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