[Congressional Record (Bound Edition), Volume 146 (2000), Part 12]
[House]
[Pages 16607-16612]
[From the U.S. 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.

[[Page 16608]]

       (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 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))

[[Page 16609]]

     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 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;

[[Page 16610]]

       (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 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

[[Page 16611]]

     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.
  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.

[[Page 16612]]

  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.

                          ____________________