[Congressional Record Volume 146, Number 100 (Thursday, July 27, 2000)]
[House]
[Pages H7177-H7181]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]
WORLD BANK AIDS MARSHALL PLAN TRUST FUND ACT
Mr. LEACH. Mr. Speaker, I ask unanimous consent to take from the
Speaker's table the bill (H.R. 3519) to provide for negotiations for
the creation of a trust fund to be administered by the International
Bank for Reconstruction and Development or the International
Development Association to combat the AIDS epidemic, with a Senate
amendment thereto, and concur in the Senate amendment.
The Clerk read the title of the bill.
The Clerk read the Senate amendment, as follows:
SENATE AMENDMENT:
Strike out all after the enacting clause and insert:
SECTION 1. SHORT TITLE.
This Act may be cited as the ``Global AIDS and Tuberculosis
Relief Act of 2000''.
SEC. 2. TABLE OF CONTENTS.
The table of contents for this Act is as follows:
Sec. 1. Short title.
Sec. 2. Table of contents.
TITLE I--ASSISTANCE TO COUNTRIES WITH LARGE POPULATIONS HAVING HIV/AIDS
Sec. 101. Short title.
Sec. 102. Definitions.
Sec. 103. Findings and purposes.
Subtitle A--United States Assistance
Sec. 111. Additional assistance authorities to combat HIV and AIDS.
Sec. 112. Voluntary contribution to Global Alliance for Vaccines and
Immunizations and International AIDS Vaccine Initiative.
Sec. 113. Coordinated donor strategy for support and education of
orphans in sub-Saharan Africa.
Sec. 114. African Crisis Response Initiative and HIV/AIDS training.
Subtitle B--World Bank AIDS Trust Fund
Chapter 1--Establishment of the Fund
Sec. 121. Establishment.
Sec. 122. Grant authorities.
Sec. 123. Administration.
Sec. 124. Advisory Board.
Chapter 2--Reports
Sec. 131. Reports to Congress.
Chapter 3--United States Financial Participation
Sec. 141. Authorization of appropriations.
Sec. 142. Certification requirement.
TITLE II--INTERNATIONAL TUBERCULOSIS CONTROL
Sec. 201. Short title.
Sec. 202. Findings.
Sec. 203. Assistance for tuberculosis prevention, treatment, control,
and elimination.
TITLE III--ADMINISTRATIVE AUTHORITIES
Sec. 301. Effective program oversight.
Sec. 302. Termination expenses.
TITLE I--ASSISTANCE TO COUNTRIES WITH LARGE POPULATIONS HAVING HIV/AIDS
SEC. 101. SHORT TITLE.
This title may be cited as the ``Global AIDS Research and
Relief Act of 2000''.
SEC. 102. DEFINITIONS.
In this title:
(1) AIDS.--The term ``AIDS'' means the acquired immune
deficiency syndrome.
(2) Association.--The term ``Association'' means the
International Development Association.
(3) Bank.--The term ``Bank'' or ``World Bank'' means the
International Bank for Reconstruction and Development.
(4) HIV.--The term ``HIV'' means the human immunodeficiency
virus, the pathogen which causes AIDS.
(5) HIV/AIDS.--The term ``HIV/AIDS'' means, with respect to
an individual, an individual who is infected with HIV or
living with AIDS.
SEC. 103. FINDINGS AND PURPOSES.
(a) Findings.--Congress makes the following findings:
(1) According to the Surgeon General of the United States,
the epidemic of human immunodeficiency virus/acquired immune
deficiency syndrome (HIV/AIDS) will soon become the worst
epidemic of infectious disease in recorded history, eclipsing
both the bubonic plague of the 1300's and the influenza
epidemic of 1918-1919 which killed more than 20,000,000
people worldwide.
(2) According to the Joint United Nations Programme on HIV/
AIDS (UNAIDS), more than 34,300,000 people in the world today
are living with HIV/AIDS, of which approximately 95 percent
live in the developing world.
(3) UNAIDS data shows that among children age 14 and under
worldwide, more than 3,800,000 have died from AIDS, more than
1,300,000 are living with the disease; and in one year
alone--1999--an estimated 620,000 became infected, of which
over 90 percent were babies born to HIV-positive women.
(4) Although sub-Saharan Africa has only 10 percent of the
world's population, it is home to more than 24,500,000--
roughly 70 percent--of the world's HIV/AIDS cases.
(5) Worldwide, there have already been an estimated
18,800,000 deaths because of HIV/AIDS, of which more than 80
percent occurred in sub-Saharan Africa.
(6) The gap between rich and poor countries in terms of
transmission of HIV from mother to child has been increasing.
Moreover, AIDS threatens to reverse years of steady progress
of child survival in developing countries. UNAIDS believes
that by the year 2010, AIDS may have increased mortality of
children under 5 years of age by more than 100 percent in
regions most affected by the virus.
(7) According to UNAIDS, by the end of 1999, 13,200,000
children have lost at least one parent to AIDS, including
12,100,000 children in sub-Saharan Africa, and are thus
considered AIDS orphans.
(8) At current infection and growth rates for HIV/AIDS, the
National Intelligence Council estimates that the number of
AIDS orphans worldwide will increase dramatically,
potentially increasing threefold or more in the next 10
years, contributing to economic decay, social fragmentation,
and political destabilization in already volatile and
strained societies. Children without care or hope are often
drawn into prostitution, crime, substance abuse, or child
soldiery.
(9) Donors must focus on adequate preparations for the
explosion in the number of orphans and the burden they will
place on families, communities, economies, and governments.
Support structures and incentives for families, communities,
and institutions which will provide care for children
orphaned by HIV/AIDS, or for the children who are themselves
afflicted by HIV/AIDS, will be essential.
(10) The 1999 annual report by the United Nations
Children's Fund (UNICEF) states ``[t]he number of orphans,
particularly in Africa, constitutes nothing less than an
emergency, requiring an emergency response'' and that
``finding the resources needed to help stabilize the crisis
and protect children is a priority that requires urgent
action from the international community.''.
(11) The discovery of a relatively simple and inexpensive
means of interrupting the transmission of HIV from an
infected mother to the unborn child--namely with nevirapine
(NVP), which costs US$4 a tablet--has created a great
opportunity for an unprecedented partnership between the
United States Government and the governments of Asian,
African and Latin American countries to reduce mother-to-
child transmission (also known as ``vertical transmission'')
of HIV.
(12) According to UNAIDS, if implemented this strategy will
decrease the proportion of orphans that are HIV-infected and
decrease infant and child mortality rates in these developing
regions.
(13) A mother-to-child antiretroviral drug strategy can be
a force for social change, providing the opportunity and
impetus needed to address often long-standing problems of
inadequate services and the profound stigma associated with
HIV-infection and the AIDS disease. Strengthening the health
infrastructure to improve mother-and-child health, antenatal,
delivery and postnatal services, and couples counseling
generates enormous spillover effects toward combating the
AIDS epidemic in developing regions.
(14) United States Census Bureau statistics show life
expectancy in sub-Saharan Africa falling to around 30 years
of age within a decade, the lowest in a century, and project
life expectancy in 2010 to be 29 years of age in Botswana, 30
years of age in Swaziland, 33 years of age in Namibia and
Zimbabwe, and 36 years of age in South Africa, Malawi, and
Rwanda, in contrast to a life expectancy of 70 years of age
in many of the countries without a high prevalence of AIDS.
(15) A January 2000 United States National Intelligence
Estimate (NIE) report on the global infectious disease threat
concluded that the economic costs of infectious diseases--
especially HIV/AIDS--are already significant and could reduce
GDP by as much as 20 percent or more by 2010 in some sub-
Saharan African nations.
(16) According to the same NIE report, HIV prevalence among
militias in Angola and the Democratic Republic of the Congo
are estimated at 40 to 60 percent, and at 15 to 30 percent in
Tanzania.
(17) The HIV/AIDS epidemic is of increasing concern in
other regions of the world, with UNAIDS estimating that there
are more than 5,600,000 cases in South and South-east Asia,
that the rate of HIV infection in the Caribbean
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is second only to sub-Saharan Africa, and that HIV infections
have doubled in just two years in the former Soviet Union.
(18) Despite the discouraging statistics on the spread of
HIV/AIDS, some developing nations--such as Uganda, Senegal,
and Thailand--have implemented prevention programs that have
substantially curbed the rate of HIV infection.
(19) AIDS, like all diseases, knows no national boundaries,
and there is no certitude that the scale of the problem in
one continent can be contained within that region.
(20) Accordingly, United States financial support for
medical research, education, and disease containment as a
global strategy has beneficial ramifications for millions of
Americans and their families who are affected by this
disease, and the entire population which is potentially
susceptible.
(b) Purposes.--The purposes of this title are to--
(1) help prevent human suffering through the prevention,
diagnosis, and treatment of HIV/AIDS; and
(2) help ensure the viability of economic development,
stability, and national security in the developing world by
advancing research to--
(A) understand the causes associated with HIV/AIDS in
developing countries; and
(B) assist in the development of an AIDS vaccine.
Subtitle A--United States Assistance
SEC. 111. ADDITIONAL ASSISTANCE AUTHORITIES TO COMBAT HIV AND
AIDS.
(a) Assistance for Prevention of HIV/AIDS and Vertical
Transmission.--Section 104(c) of the Foreign Assistance Act
of 1961 (22 U.S.C. 2151b(c)) is amended by adding at the end
the following new paragraphs:
``(4)(A) Congress recognizes the growing international
dilemma of children with the human immunodeficiency virus
(HIV) and the merits of intervention programs aimed at this
problem. Congress further recognizes that mother-to-child
transmission prevention strategies can serve as a major force
for change in developing regions, and it is, therefore, a
major objective of the foreign assistance program to control
the acquired immune deficiency syndrome (AIDS) epidemic.
``(B) The agency primarily responsible for administering
this part shall--
``(i) coordinate with UNAIDS, UNICEF, WHO, national and
local governments, and other organizations to develop and
implement effective strategies to prevent vertical
transmission of HIV; and
``(ii) coordinate with those organizations to increase
intervention programs and introduce voluntary counseling and
testing, antiretroviral drugs, replacement feeding, and other
strategies.
``(5)(A) Congress expects the agency primarily responsible
for administering this part to make the human
immunodeficiency virus (HIV) and the acquired immune
deficiency syndrome (AIDS) a priority in the foreign
assistance program and to undertake a comprehensive,
coordinated effort to combat HIV and AIDS.
``(B) Assistance described in subparagraph (A) shall
include help providing--
``(i) primary prevention and education;
``(ii) voluntary testing and counseling;
``(iii) medications to prevent the transmission of HIV from
mother to child; and
``(iv) care for those living with HIV or AIDS.
``(6)(A) In addition to amounts otherwise available for
such purpose, there is authorized to be appropriated to the
President $300,000,000 for each of the fiscal years 2001 and
2002 to carry out paragraphs (4) and (5).
``(B) Of the funds authorized to be appropriated under
subparagraph (A), not less than 65 percent is authorized to
be available through United States and foreign
nongovernmental organizations, including private and
voluntary organizations, for-profit organizations, religious
affiliated organizations, educational institutions, and
research facilities.
``(C)(i) Of the funds authorized to be appropriated by
subparagraph (A), not less than 20 percent is authorized to
be available for programs as part of a multidonor strategy to
address the support and education of orphans in sub-Saharan
Africa, including AIDS orphans.
``(ii) Assistance made available under this subsection, and
assistance made available under chapter 4 of part II to carry
out the purposes of this subsection, may be made available
notwithstanding any other provision of law that restricts
assistance to foreign countries.
``(D) Of the funds authorized to be appropriated under
subparagraph (A), not less than 8.3 percent is authorized to
be available to carry out the prevention strategies for
vertical transmission referred to in paragraph (4)(A).
``(E) Of the funds authorized to be appropriated by
subparagraph (A), not more than 7 percent may be used for the
administrative expenses of the agency primarily responsible
for carrying out this part of this Act in support of
activities described in paragraphs (4) and (5).
``(F) Funds appropriated under this paragraph are
authorized to remain available until expended.''.
(b) Training and Training Facilities in Sub-Saharan
Africa.--Section 496(i)(2) of the Foreign Assistance Act of
1961 (22 U.S.C. 2293(i)(2)) is amended by adding at the end
the following new sentence: ``In addition, providing training
and training facilities, in sub-Saharan Africa, for doctors
and other health care providers, notwithstanding any
provision of law that restricts assistance to foreign
countries.''.
SEC. 112. VOLUNTARY CONTRIBUTION TO GLOBAL ALLIANCE FOR
VACCINES AND IMMUNIZATIONS AND INTERNATIONAL
AIDS VACCINE INITIATIVE.
(a) Authorization of Appropriations.--Section 302 of the
Foreign Assistance Act of 1961 (22 U.S.C. 2222) is amended by
adding at the end the following new subsections:
``(k) In addition to amounts otherwise available under this
section, there is authorized to be appropriated to the
President $50,000,000 for each of the fiscal years 2001 and
2002 to be available only for United States contributions to
the Global Alliance for Vaccines and Immunizations.
``(l) In addition to amounts otherwise available under this
section, there is authorized to be appropriated to the
President $10,000,000 for each of the fiscal years 2001 and
2002 to be available only for United States contributions to
the International AIDS Vaccine Initiative.''.
(b) Report.--At the close of fiscal year 2001, the
President shall submit a report to the appropriate
congressional committees on the effectiveness of the Global
Alliance for Vaccines and Immunizations and the International
AIDS Vaccine Initiative during that fiscal year in meeting
the goals of--
(1) improving access to sustainable immunization services;
(2) expanding the use of all existing, safe, and cost-
effective vaccines where they address a public health
problem;
(3) accelerating the development and introduction of new
vaccines and technologies;
(4) accelerating research and development efforts for
vaccines needed primarily in developing countries; and
(5) making immunization coverage a centerpiece in
international development efforts.
(c) Appropriate Congressional Committees Defined.--In
subsection (b), the term ``appropriate congressional
committees'' means the Committee on Foreign Relations and the
Committee on Appropriations of the Senate and the Committee
on International Relations and the Committee on
Appropriations of the House of Representatives.
SEC. 113. COORDINATED DONOR STRATEGY FOR SUPPORT AND
EDUCATION OF ORPHANS IN SUB-SAHARAN AFRICA.
(a) Statement of Policy.--It is in the national interest of
the United States to assist in mitigating the burden that
will be placed on sub-Saharan African social, economic, and
political institutions as these institutions struggle with
the consequences of a dramatically increasing AIDS orphan
population, many of whom are themselves infected by HIV and
living with AIDS. Effectively addressing that burden and its
consequences in sub-Saharan Africa will require a coordinated
multidonor strategy.
(b) Development of Strategy.--The President shall
coordinate the development of a multidonor strategy to
provide for the support and education of AIDS orphans and the
families, communities, and institutions most affected by the
HIV/AIDS epidemic in sub-Saharan Africa.
(c) Definition.--In this section, the term ``HIV/AIDS''
means, with respect to an individual, an individual who is
infected with the human immunodeficiency virus (HIV), the
pathogen that causes the acquired immune deficiency virus
(AIDS), or living with AIDS.
SEC. 114. AFRICAN CRISIS RESPONSE INITIATIVE AND HIV/AIDS
TRAINING.
(a) Findings.--Congress finds that--
(1) the spread of HIV/AIDS constitutes a threat to security
in Africa;
(2) civil unrest and war may contribute to the spread of
the disease to different parts of the continent;
(3) the percentage of soldiers in African militaries who
are infected with HIV/AIDS is unknown, but estimates range in
some countries as high as 40 percent; and
(4) it is in the interests of the United States to assist
the countries of Africa in combating the spread of HIV/AIDS.
(b) Education on the Prevention of the Spread of AIDS.--In
undertaking education and training programs for military
establishments in African countries, the United States shall
ensure that classroom training under the African Crisis
Response Initiative includes military-based education on the
prevention of the spread of AIDS.
Subtitle B--World Bank AIDS Trust Fund
CHAPTER 1--ESTABLISHMENT OF THE FUND
SEC. 121. ESTABLISHMENT.
(a) Negotiations for Establishment of Trust Fund.--The
Secretary of the Treasury shall seek to enter into
negotiations with the World Bank or the Association, in
consultation with the Administrator of the United States
Agency for International Development and other United States
Government agencies, and with the member nations of the World
Bank or the Association and with other interested parties,
for the establishment within the World Bank of--
(1) the World Bank AIDS Trust Fund (in this subtitle
referred to as the ``Trust Fund'') in accordance with the
provisions of this chapter; and
(2) the Advisory Board to the Trust Fund in accordance with
section 124.
(b) Purpose.--The purpose of the Trust Fund should be to
use contributed funds to--
(1) assist in the prevention and eradication of HIV/AIDS
and the care and treatment of individuals infected with HIV/
AIDS; and
(2) provide support for the establishment of programs that
provide health care and primary and secondary education for
children orphaned by the HIV/AIDS epidemic.
(c) Composition.--
(1) In general.--The Trust Fund should be governed by a
Board of Trustees, which should be composed of
representatives of the participating donor countries to the
Trust Fund. Individuals appointed to the Board should have
demonstrated knowledge and experience in the fields of public
health, epidemiology, health care (including delivery
systems), and development.
(2) United states representation.--
(A) In general.--Upon the effective date of this paragraph,
there shall be a United States
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member of the Board of Trustees, who shall be appointed by
the President, by and with the advice and consent of the
Senate, and who shall have the qualifications described in
paragraph (1).
(B) Effective and termination dates.--
(i) Effective date.--This paragraph shall take effect upon
the date the Secretary of the Treasury certifies to Congress
that an agreement establishing the Trust Fund and providing
for a United States member of the Board of Trustees is in
effect.
(ii) Termination date.--The position established by
subparagraph (A) is abolished upon the date of termination of
the Trust Fund.
SEC. 122. GRANT AUTHORITIES.
(a) Program objectives.--
(1) In general.--In carrying out the purpose of section
121(b), the Trust Fund, acting through the Board of Trustees,
should provide only grants, including grants for technical
assistance to support measures to build local capacity in
national and local government, civil society, and the private
sector to lead and implement effective and affordable HIV/
AIDS prevention, education, treatment and care services, and
research and development activities, including access to
affordable drugs.
(2) Activities supported.--Among the activities the Trust
Fund should provide grants for should be--
(A) programs to promote the best practices in prevention,
including health education messages that emphasize risk
avoidance such as abstinence;
(B) measures to ensure a safe blood supply;
(C) voluntary HIV/AIDS testing and counseling;
(D) measures to stop mother-to-child transmission of HIV/
AIDS, including through diagnosis of pregnant women, access
to cost-effective treatment and counseling, and access to
infant formula or other alternatives for infant feeding;
(E) programs to provide for the support and education of
AIDS orphans and the families, communities, and institutions
most affected by the HIV/AIDS epidemic;
(F) measures for the deterrence of gender-based violence
and the provision of post-exposure prophylaxis to victims of
rape and sexual assault; and
(G) incentives to promote affordable access to treatments
against AIDS and related infections.
(3) Implementation of program objectives.--In carrying out
the objectives of paragraph (1), the Trust Fund should
coordinate its activities with governments, civil society,
nongovernmental organizations, the Joint United Nations
Program on HIV/AIDS (UNAIDS), the International Partnership
Against AIDS in Africa, other international organizations,
the private sector, and donor agencies working to combat the
HIV/AIDS crisis.
(b) Priority.--In providing grants under this section, the
Trust Fund should give priority to countries that have the
highest HIV/AIDS prevalence rate or are at risk of having a
high HIV/AIDS prevalence rate.
(c) Eligible Grant Recipients.--Governments and
nongovernmental organizations should be eligible to receive
grants under this section.
(d) Prohibition.--The Trust Fund should not make grants for
the purpose of project development associated with bilateral
or multilateral bank loans.
SEC. 123. ADMINISTRATION.
(a) Appointment of an Administrator.--The Board of
Trustees, in consultation with the appropriate officials of
the Bank, should appoint an Administrator who should be
responsible for managing the day-to-day operations of the
Trust Fund.
(b) Authority to Solicit and Accept Contributions.--The
Trust Fund should be authorized to solicit and accept
contributions from governments, the private sector, and
nongovernmental entities of all kinds.
(c) Accountability of Funds and Criteria for Programs.--As
part of the negotiations described in section 121(a), the
Secretary of the Treasury shall, consistent with subsection
(d)--
(1) take such actions as are necessary to ensure that the
Bank or the Association will have in effect adequate
procedures and standards to account for and monitor the use
of funds contributed to the Trust Fund, including the cost of
administering the Trust Fund; and
(2) seek agreement on the criteria that should be used to
determine the programs and activities that should be assisted
by the Trust Fund.
(d) Selection of projects and recipients.--The Board of
Trustees should establish--
(1) criteria for the selection of projects to receive
support from the Trust Fund;
(2) standards and criteria regarding qualifications of
recipients of such support;
(3) such rules and procedures as may be necessary for cost-
effective management of the Trust Fund; and
(4) such rules and procedures as may be necessary to ensure
transparency and accountability in the grant-making process.
(e) Transparency of operations.--The Board of Trustees
should ensure full and prompt public disclosure of the
proposed objectives, financial organization, and operations
of the Trust Fund.
SEC. 124. ADVISORY BOARD.
(a) In General.--There should be an Advisory Board to the
Trust Fund.
(b) Appointments.--The members of the Advisory Board should
be drawn from--
(1) a broad range of individuals with experience and
leadership in the fields of development, health care
(especially HIV/AIDS), epidemiology, medicine, biomedical
research, and social sciences; and
(2) representatives of relevant United Nations agencies and
nongovernmental organizations with on-the-ground experience
in affected countries.
(c) Responsibilities.--The Advisory Board should provide
advice and guidance to the Board of Trustees on the
development and implementation of programs and projects to be
assisted by the Trust Fund and on leveraging donations to the
Trust Fund.
(d) Prohibition on Payment of Compensation.--
(1) In general.--Except for travel expenses (including per
diem in lieu of subsistence), no member of the Advisory Board
should receive compensation for services performed as a
member of the Board.
(2) United states representative.--Notwithstanding any
other provision of law (including an international
agreement), a representative of the United States on the
Advisory Board may not accept compensation for services
performed as a member of the Board, except that such
representative may accept travel expenses, including per diem
in lieu of subsistence, while away from the representative's
home or regular place of business in the performance of
services for the Board.
CHAPTER 2--REPORTS
SEC. 131. REPORTS TO CONGRESS.
(a) Annual Reports by Treasury Secretary.--
(1) In general.--Not later than 1 year after the date of
enactment of this Act, and annually thereafter for the
duration of the Trust Fund, the Secretary of the Treasury
shall submit to the appropriate committees of Congress a
report on the Trust Fund.
(2) Report elements.--The report shall include a
description of--
(A) the goals of the Trust Fund;
(B) the programs, projects, and activities, including any
vaccination approaches, supported by the Trust Fund;
(C) private and governmental contributions to the Trust
Fund; and
(D) the criteria that have been established, acceptable to
the Secretary of the Treasury and the Administrator of the
United States Agency for International Development, that
would be used to determine the programs and activities that
should be assisted by the Trust Fund.
(b) GAO Report on Trust Fund Effectiveness.--Not later than
2 years after the date of enactment of this Act, the
Comptroller General of the United States shall submit to the
appropriate committees of the Congress a report evaluating
the effectiveness of the Trust Fund, including--
(1) the effectiveness of the programs, projects, and
activities described in subsection (a)(2)(B) in reducing the
worldwide spread of AIDS; and
(2) an assessment of the merits of continued United States
financial contributions to the Trust Fund.
(c) Appropriate Committees Defined.--In subsection (a), the
term ``appropriate committees'' means the Committee on
Foreign Relations and the Committee on Appropriations of the
Senate and the Committee on International Relations, the
Committee on Banking and Financial Services, and the
Committee on Appropriations of the House of Representatives.
CHAPTER 3--UNITED STATES FINANCIAL PARTICIPATION
SEC. 141. AUTHORIZATION OF APPROPRIATIONS.
(a) In General.--In addition to any other funds authorized
to be appropriated for multilateral or bilateral programs
related to HIV/AIDS or economic development, there is
authorized to be appropriated to the Secretary of the
Treasury $150,000,000 for each of the fiscal years 2001 and
2002 for payment to the Trust Fund.
(b) Allocation of Funds.--Of the amounts authorized to be
appropriated by subsection (a) for the fiscal years 2001 and
2002, $50,000,000 are authorized to be available each such
fiscal year only for programs that benefit orphans.
SEC. 142. CERTIFICATION REQUIREMENT.
(a) In General.--Prior to the initial obligation or
expenditure of funds appropriated pursuant to section 141,
the Secretary of the Treasury shall certify that adequate
procedures and standards have been established to ensure
accountability for and monitoring of the use of funds
contributed to the Trust Fund, including the cost of
administering the Trust Fund.
(b) Transmittal of Certification.--The certification
required by subsection (a), and the bases for that
certification, shall be submitted by the Secretary of the
Treasury to Congress.
TITLE II--INTERNATIONAL TUBERCULOSIS CONTROL
SEC. 201. SHORT TITLE.
This title may be cited as the ``International Tuberculosis
Control Act of 2000''.
SEC. 202. FINDINGS.
Congress makes the following findings:
(1) Since the development of antibiotics in the 1950s,
tuberculosis has been largely controlled in the United States
and the Western World.
(2) Due to societal factors, including growing urban decay,
inadequate health care systems, persistent poverty,
overcrowding, and malnutrition, as well as medical factors,
including the HIV/AIDS epidemic and the emergence of multi-
drug resistant strains of tuberculosis, tuberculosis has
again become a leading and growing cause of adult deaths in
the developing world.
(3) According to the World Health Organization--
(A) in 1998, about 1,860,000 people worldwide died of
tuberculosis-related illnesses;
(B) one-third of the world's total population is infected
with tuberculosis; and
(C) tuberculosis is the world's leading killer of women
between 15 and 44 years old and is a leading cause of
children becoming orphans.
(4) Because of the ease of transmission of tuberculosis,
its international persistence and growth pose a direct public
health threat to those nations that had previously largely
controlled the disease. This is complicated in the United
States by the growth of the homeless
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population, the rate of incarceration, international travel,
immigration, and HIV/AIDS.
(5) With nearly 40 percent of the tuberculosis cases in the
United States attributable to foreign-born persons,
tuberculosis will never be controlled in the United States
until it is controlled abroad.
(6) The means exist to control tuberculosis through
screening, diagnosis, treatment, patient compliance,
monitoring, and ongoing review of outcomes.
(7) Efforts to control tuberculosis are complicated by
several barriers, including--
(A) the labor intensive and lengthy process involved in
screening, detecting, and treating the disease;
(B) a lack of funding, trained personnel, and medicine in
virtually every nation with a high rate of the disease;
(C) the unique circumstances in each country, which
requires the development and implementation of country-
specific programs; and
(D) the risk of having a bad tuberculosis program, which is
worse than having no tuberculosis program because it would
significantly increase the risk of the development of more
widespread drug-resistant strains of the disease.
(8) Eliminating the barriers to the international control
of tuberculosis through a well-structured, comprehensive, and
coordinated worldwide effort would be a significant step in
dealing with the increasing public health problem posed by
the disease.
SEC. 203. ASSISTANCE FOR TUBERCULOSIS PREVENTION, TREATMENT,
CONTROL, AND ELIMINATION.
Section 104(c) of the Foreign Assistance Act of 1961 (22
U.S.C. 2151b(c)), as amended by section 111(a) of this Act,
is further amended by adding at the end the following:
``(7)(A) Congress recognizes the growing international
problem of tuberculosis and the impact its continued
existence has on those nations that had previously largely
controlled the disease. Congress further recognizes that the
means exist to control and treat tuberculosis, and that it is
therefore a major objective of the foreign assistance program
to control the disease. To this end, Congress expects the
agency primarily responsible for administering this part--
``(i) to coordinate with the World Health Organization, the
Centers for Disease Control, the National Institutes of
Health, and other organizations toward the development and
implementation of a comprehensive tuberculosis control
program; and
``(ii) to set as a goal the detection of at least 70
percent of the cases of infectious tuberculosis, and the cure
of at least 85 percent of the cases detected, in those
countries in which the agency has established development
programs, by December 31, 2010.
``(B) There is authorized to be appropriated to the
President, $60,000,000 for each of the fiscal years 2001 and
2002 to be used to carry out this paragraph. Funds
appropriated under this subparagraph are authorized to remain
available until expended.''.
TITLE III--ADMINISTRATIVE AUTHORITIES
SEC. 301. EFFECTIVE PROGRAM OVERSIGHT.
Section 635 of the Foreign Assistance Act of 1961 (22
U.S.C. 2395) is amended by adding at the end thereof the
following new subsection:
``(l) The Administrator of the agency primarily responsible
for administering part I may use funds made available under
that part to provide program and management oversight for
activities that are funded under that part and that are
conducted in countries in which the agency does not have a
field mission or office.''.
SEC. 302. TERMINATION EXPENSES.
Section 617 of the Foreign Assistance Act of 1961 (22
U.S.C. 2367) is amended to read as follows:
``SEC. 617. TERMINATION EXPENSES.
``(a) In General.--Funds made available under this Act and
the Arms Export Control Act, may remain available for
obligation for a period not to exceed 8 months from the date
of any termination of assistance under such Acts for the
necessary expenses of winding up programs related to such
termination and may remain available until expended. Funds
obligated under the authority of such Acts prior to the
effective date of the termination of assistance may remain
available for expenditure for the necessary expenses of
winding up programs related to such termination
notwithstanding any provision of law restricting the
expenditure of funds. In order to ensure the effectiveness of
such assistance, such expenses for orderly termination of
programs may include the obligation and expenditure of funds
to complete the training or studies outside their countries
of origin of students whose course of study or training
program began before assistance was terminated.
``(b) Liability to Contractors.--For the purpose of making
an equitable settlement of termination claims under
extraordinary contractual relief standards, the President is
authorized to adopt as a contract or other obligation of the
United States Government, and assume (in whole or in part)
any liabilities arising thereunder, any contract with a
United States or third-country contractor that had been
funded with assistance under such Acts prior to the
termination of assistance.
``(c) Termination Expenses.--Amounts certified as having
been obligated for assistance subsequently terminated by the
President, or pursuant to any provision of law, shall
continue to remain available and may be reobligated to meet
any necessary expenses arising from the termination of such
assistance.
``(d) Guaranty Programs.--Provisions of this or any other
Act requiring the termination of assistance under this or any
other Act shall not be construed to require the termination
of guarantee commitments that were entered into prior to the
effective date of the termination of assistance.
``(e) Relation to Other Provisions.--Unless specifically
made inapplicable by another provision of law, the provisions
of this section shall be applicable to the termination of
assistance pursuant to any provision of law.''.
The SPEAKER pro tempore (during the reading). Without objection, the
Senate amendment is considered as read and printed in the Record.
There was no objection.
The SPEAKER pro tempore. Is there objection to the request of the
gentleman from Iowa?
Ms. LEE. Mr. Speaker, reserving the right to object, first I would
like to thank the gentleman from Iowa (Mr. Leach) and the gentleman
from New York (Mr. LaFalce) for their tremendous leadership on this
issue. I would also like to thank my colleagues on the Committee on
Banking and Financial Services. I would also, in addition, like to
thank the Committee on Banking and Financial Services staff and the
committee staff of the Committee on International Relations as well as
my own staff for their hard work. But I want to especially thank my
senior legislative assistant, Michael Riggs, who has worked tirelessly
on this effort.
I must also recognize and give credit really to my predecessor and a
great statesman, Congressman Ron Dellums, and members of the
Congressional Black Caucus for their strong support. Ron has been
sounding the clarion call about this pandemic of HIV/AIDS globally for
many years. The drumbeat is now being heard. Today we see the
collective work of Members of Congress, the Clinton administration,
HIV/AIDS specialists and activists, faith-based communities, Africans,
and the business community coming together.
At this moment, the global AIDS crisis is the most urgent
humanitarian crisis of our time. It is estimated that 6,000 people die
each day of AIDS in Africa. Since I introduced the AIDS Marshall Plan
last August, nearly 3 million people have died.
This is not a Democratic issue, nor is it a Republican issue. It is a
moral issue that demands a moral response. AIDS, like all diseases,
knows no boundaries. There is no guarantee that the scale of the
problem in one continent can be contained within that region.
So our message is clear. Today with the passage of this bill we will
press forward with our commitment to fight the war against HIV/AIDS and
to stem the tide of death. We know that with resources we can fight
this war and save lives and prevent the spread of HIV/AIDS.
Today we are taking a major step in the right direction. I am
confident that the bill that we pass today will push us even further in
our commitment to fighting AIDS in Africa. I believe that the quick
pace at which we are moving reflects the urgency of this crisis.
Again, I want to thank the gentleman from Iowa (Mr. Leach) and the
gentleman from New York (Mr. LaFalce). I want to say that today we are
showing America and we are showing the world that Africa and the fate
of humanity really does matter and that the United States is prepared
to show leadership in the fight against HIV/AIDS. This is really a
defining moment for us all. It is a historic day. I am pleased that we
are approving this important piece of legislation.
Mr. LEACH. Mr. Speaker, will the gentlewoman yield?
Ms. LEE. Further reserving the right to object, I yield to the
gentleman from Iowa.
Mr. LEACH. Mr. Speaker, I would like to simply thank the gentlewoman
for her leadership, also that of her predecessor whom she mentioned,
Mr. Dellums; staff, as well as, frankly, Mrs. Fogleman on our staff and
Mr. McCormick on our staff and the Senate leadership and staff of the
Senate Foreign Relations Committee that has worked so closely with us.
By perspective, let me just very briefly say that nothing is more
difficult than to provide some sort of perspective to issues of the
day, but if we look at the 14th century, 20 million people died of the
bubonic plague, and it would be hard to conclude that that was not the
most important incident of the century. Today we have almost reached
that figure with AIDS. Within a decade we may be at a multiple of that
figure. It is anything but inconceivable not to conclude that
exterminating this deadly disease is not the most important issue of
our age.
[[Page H7181]]
This approach that we have adopted is seminal. It is a part of the
picture of dealing with AIDS, not the whole picture but a very
significant part and with the combination of reduction in debt burdens
of the developing world stands as the most significant effort the
United States Congress has ever taken for the developing world and one
of the most significant efforts the United States Congress has ever
taken towards disease control and prevention.
This is an extraordinary, symbolic measure, one that we are going to
have to build upon but a firm and thoughtful step in the right
direction. Let me thank the gentlewoman again for her help and
leadership in this cause.
Mr. LaFALCE. Mr. Speaker, I want to express my thanks to Chairman
Leach and to Chairman Gilman for the cooperation they have shown in
bringing this Senate amended language to the floor on an expedited
basis. I also offer my congratulations to Congresswoman Barbara Lee for
her initiative on, and consistent commitment to, this legislation.
Without her, this much-needed bill would not be becoming law. Moreover,
she has led the fight for appropriations for this trust fund that will
help the World Bank tackle the scourges of AIDS and tuberculosis that
so tragically threatens the lives of too many people in Africa. No
outcome was more gratifying than the amendment to the Foreign
Operations Appropriations bill that obtained funding for this
legislation.
This country has a proud and longstanding tradition of providing
humanitarian assistance--especially in a crisis. HIV/AIDS is an
international epidemic of crisis proportions. The HIV/AIDS pandemic
could come to rival, in other parts of the world, the destructive
bubonic plague of the 1300s that devastated the continent of Europe.
Worldwide, HIV/AIDS has infected millions. Yet worldwide, we spend so
very little to fight the disease and contain the pandemic. As we all
know, although Sub-Saharan Africa has only 10 percent of the world's
population, it suffers roughly 70 percent of the HIV/AIDS cases. We
also know that if HIV/AIDS reaches a certain prevalence, it can
explosively infect a population, and some areas in addition to Africa
are threatened. No country in the world seriously threatened by this
disease and unable to fight it alone should be ignored by our efforts.
Taking targeted and expeditious action to begin to fight the AIDS
pandemic is both the moral and the sensible thing to do. Although there
is as yet no known cure for the disease, we can make meaningful
progress in containing it.
This trust fund has many unique features. None is more prominent than
that the fund can receive contributions from anyone, not merely
governments that are members of the World Bank. Moreover, these
contributions will be deductible or expensible for the contributor.
Consequently, although our government's share will be significant, the
promise is great for leveraging this fund into a very large resource
base to combat the worst plague to hit mankind since the Black Death in
the Middle Ages.
Both the House and the Senate have appropriately provided for
oversight of the monies in the fund. Many of the nations where AIDS/HIV
is prevalent are also nations where corruption is highest.
Consequently, the trust fund is endowed with effective monitoring
devices to detect the illicit.
However, these safeguards are not so burdensome that the trust fund
will be unduly hamstrung. Indeed, another unique feature of this fund
is that its uses are so flexible. AIDS is a cunning enemy. The course
and form differs from area to area. In some, education is the most
effective weapon. In others, drugs, such as forms of AZT, can do the
most good. The trust fund is not locked into one approach but is free
to use all of them as circumstances warrant.
This will not be the last bill to come to this floor on AIDS. We now
know the raw statistics on how the plague is totally out of control
throughout a significant portion of the world. We now also know that
even here, where there has been some progress against this disease,
that this progress can be reversed. Consequently, for an undetermined
number of Congresses to come, this chamber will be grappling with this
opponent. However, the legislation we pass today and send to the
President is a substantial step in the right direction.
Ms. LEE. Mr. Speaker, I withdraw my reservation of objection.
The SPEAKER pro tempore. Is there objection to the request of the
gentleman from Iowa?
There was no objection.
A motion to reconsider was laid on the table.
____________________