[Congressional Record Volume 159, Number 164 (Monday, November 18, 2013)]
[Senate]
[Pages S8136-S8140]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




              PEPFAR STEWARDSHIP AND OVERSIGHT ACT OF 2013

  Mrs. BOXER. Mr. President, I ask unanimous consent that the Senate 
proceed to the immediate consideration of Calendar No. 202, S. 1545.
  The PRESIDING OFFICER. The clerk will report the bill by title.
  The legislative clerk read as follows:

       A bill (S. 1545) to extend authorities related to global 
     HIV/AIDS and to promote oversight of United States programs.
  There being no objection, the Senate proceeded to consider the bill 
which

[[Page S8137]]

had been reported from the Committee on Foreign Relations, with 
amendments, as follows:
       (The parts of the bill intended to be stricken are shown in 
     boldface brackets and the parts of the bill intended to be 
     inserted are shown in italics.)

                                S. 1545

       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 [annually] 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 
     prevention, care, and treatment as practicable] 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.
       ``[2](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.

[[Page S8138]]

       ``(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 [including 
     management of co-morbidities]
       ``(H) A description of [national] 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, [community 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.
       ``[(3)](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 [annually] 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)''.
  Mrs. BOXER. Mr. President, I ask unanimous consent that the 
committee-reported amendments be agreed to as original text, the 
Menendez-Corker amendment, which is at the desk, be agreed to, the 
bill, as amended, be read a third time and passed, and the motion to 
reconsider be considered made and laid upon the table, with no 
intervening action or debate.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  The committee-reported amendments were agreed to.
  The amendment (No. 2147) was agreed to, as follows:

         (Purpose: To require reporting on program evaluations)

       On page 18, strike line 11 and insert the following:
       ``(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
       On page 16, line 3, strike ``counties'' and insert 
     ``countries''.
       On page 18, line 1, strike the second set of quotation 
     marks.
       On page 18, line 4, strike the second set of quotation 
     marks.

  The bill (S. 1545), as amended, was ordered to be engrossed for a 
third reading, was read the third time, and passed, as follows:

                                S. 1545

       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

[[Page S8139]]

       (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

[[Page S8140]]

       ``(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)''.

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