[Senate Report 106-336]
[From the U.S. Government Publishing Office]



                                                       Calendar No. 671
106th Congress                                                   Report
                                 SENATE
 2d Session                                                     106-336

======================================================================



 
                THE GLOBAL AIDS AND TUBERCULOSIS RELIEF
                              ACT OF 2000

                                _______
                                

                 July 11, 2000.--Ordered to be printed

                                _______
                                

          Mr. Helms, from the Committee on Foreign Relations,
                        submitted the following

                              R E P O R T

                         [To accompany S. 2845]

    The Committee on Foreign Relations, having had under 
consideration an original bill to authorize additional 
assistance to countries with large populations having HIV/AIDS, 
to authorize assistance for tuberculosis prevention, treatment, 
control, and elimination, and for other purposes, reports 
favorably thereon and recommends that the bill do pass.

                                CONTENTS

                                                                   Page

  I. Committee Action.................................................1
 II. Section-by-Section Analysis......................................2
III. Cost Estimate....................................................6
 IV. Evaluation of Regulatory Impact..................................8
  V. Changes in Existing Law..........................................8

                          I. Committee Action

    On March 23, 2000 the Committee unanimously ordered 
reported S. 2382, the Technical Assistance, Trade Promotion and 
Anti-Corruption Act of 2000. S. 2382 was reported and placed on 
the Senate Legislative Calendar on April 7, 2000, and 
subsequently referred to the Committee on Banking, Housing, and 
Urban Affairs pursuant to paragraph 1(j)(10) of rule XXV of the 
Standing Rules of the Senate on April 11, 2000. Paragraph 
1(j)(10) of rule XXV of the Standing Rules of the Senate 
provides that, ``at the request of the Committee on Banking, 
Housing, and Urban Affairs, any proposed legislation relating 
to [the International Monetary Fund] reported by the Committee 
on Foreign Relations shall be referred to the Committee on 
Banking, Housing, and Urban Affairs.'' The Banking Committee 
has taken no action on S. 2382 as of the writing of this 
report.
    On Wednesday, June 28, 2000, the Committee on Foreign 
Relations considered and unanimously approved by voice vote the 
Global AIDS Research and Relief Act of 2000, which is identical 
to Subtitles D and E of S. 2382, the Technical Assistance, 
Trade Promotion, and Anti-Corruption Act of 2000.

                    II. Section-by-Section Analysis


TITLE I--ASSISTANCE TO COUNTRIES WITH LARGE POPULATIONS HAVING HIV/AIDS


Sec. 101. Short Title

    This section designates this title as the ``Global AIDS 
Research and Relief Act of 2000.''

Sec. 102. Definitions

    This section defines four terms used in this subtitle: 
AIDS, Association (International Development Association), Bank 
(World Bank), HIV, and HIV/AIDS (an individual having HIV but 
not AIDS, or an individual having HIV and AIDS).

Sec. 103. Findings and Purposes

    Section 103 sets out a number of Congressional findings 
concerning the global AIDS epidemic and identifies two main 
purposes of this subtitle. World Bank data show that over 90 
percent of people with HIV/AIDS live in the developing world. 
Nearly two-thirds of adults and children suffering from HIV/
AIDS live in sub-Saharan Africa, while another 24 percent live 
in Asia. Already, nearly 4.5 million children under the age of 
15 have been infected with HIV, and of these 3 million have 
died of AIDS. This situation threatens to reverse years of 
progress of child survival in developing nations. The World 
Bank calls AIDS the ``foremost and fastest-growing threat to 
development'' in Africa, and has declared its new HIV/AIDS in 
Africa initiative its top priority for the region. The 
discovery of a relatively simple and inexpensive treatment--
navirapine (NVP)--to interrupt the transmission of HIV from an 
infected mother to an unborn or newly born child presents an 
extraordinary opportunity for the U.S. Government to partner 
with governments in the developing world to fight the mother-
to-child transmission of HIV, known as ``vertical 
transmission.'' If the current infection growth rates continue, 
the number of AIDS orphans may triple during the next 10 years, 
posing substantial economic, social, and political 
consequences. An expansive mother-to-child antiretroviral drug 
strategy can be a significant force for social change and play 
a critical role in confronting the HIV/AIDS epidemic in the 
developing world. The U.N. estimates that an additional 400 to 
800 children are infected with HIV each day through breast 
feeding in many African countries. According to the 
Congressional testimony by U.N. Ambassador Richard Holbrooke, 
the single most important step in preventing the transmission 
of the HIV virus in Africa is to provide HIV-positive pregnant 
women and nursing mothers with practical alternatives to breast 
feeding. The Committee expects USAID to address this issue and 
to coordinate with relevant U.N. agencies to prevent the 
transmission of HIV through breast feeding.
    Subsection (b) states two purposes of the title: (1) to 
prevent human suffering; and (2) to ensure economic 
development, stability, and national security in developing 
nations by advancing research to better understand the causes 
of HIV/AIDS and help in the development of an AIDS vaccine.

Sec. 104. Additional Assistance Authorities to Combat HIV and AIDS

    Section 104 amends the Foreign Assistance Act of 1961 (FAA) 
by adding additional authorities for USAID to engage in HIV/
AIDS activities.
    Specifically, subsection (a) directs USAID to coordinate 
with UNAIDS, UNICEF, WHO, local governments, and other 
organizations to create strategies to prevent HIV vertical 
transmission and implement intervention programs, and to 
continue programs for voluntary counseling and testing, the 
distribution of antiretroviral drugs and replacement feeding. 
The Committee expects USAID to pursue comprehensive, 
coordinated efforts to fight HIV and AIDS, making such efforts 
a priority of U.S. foreign assistance. USAID assistance should 
focus on primary prevention and education, voluntary testing 
and counseling, the provision of medications preventing the 
transmission of HIV and AIDS from mother to child, and care for 
those living with HIV and AIDS.
    The provision authorizes the appropriation of $300 million, 
in addition to funds otherwise available to implement the 
programs under this subsection. At least 65 percent of these 
funds are authorized for U.S. and foreign nongovernmental 
organizations, including private and voluntary organizations, 
for-profit organizations, religious affiliated organizations, 
educational organizations, and research facilities. Not less 
than 20 percent of these funds are authorized for programs that 
are part of a multidonor strategy to support and educate 
orphans in Africa, including AIDS orphans. Vertical 
transmission prevention activities are authorized to receive 
not less than 8.3 percent of the $300 million authorization. 
Finally, no more than 7 percent of the $300 million may be used 
to administer programs carried out under this subsection. The 
authorizations in section 243 reflect the importance the 
Committee places on nongovernmental organizations which play a 
vital role to combat HIV/AIDS and the Committee's belief that 
particular emphasis must be placed on the care and education of 
children orphaned by AIDS. However, the Committee also expects 
USAID to continue to support efforts of responsible 
governments, in Africa and elsewhere, to provide leadership and 
develop programs to reduce the incidences of AIDS in their 
countries. Ultimately the HIV/AIDS problem cannot be addressed 
without the involvement and cooperation of governments who 
understand the breadth of the problem and the urgent need to 
address it.
    Subsection (b) amends section 496 of the FAA (dealing with 
the Development Fund for Africa) by inserting the authority to 
waive any restrictions on aid to countries for the provision of 
assistance for training and training facilities in sub-Saharan 
Africa, for doctors and other health care providers.

Sec. 105. Voluntary Contribution to Global Alliance for Vaccines and 
        Immunizations and International AIDS Vaccine Initiative

    This section amends section 302 of the FAA authorizing $50 
million in fiscal year 2001 for a U.S. contribution to the 
Global Alliance for Vaccines and Immunizations (GAVI), and $10 
million for the International AIDS Vaccine Initiative. The 
President must further report at the end of fiscal year 2001 on 
the effectiveness of GAVI and the International AIDS Vaccine 
Initiative in meeting several goals.

Sec. 106. Multilateral Lifesaving Vaccine Purchase Fund

    This section urges the President to begin negotiations with 
foreign governments and other interested institutions and 
parties to establish an international vaccine purchase fund 
that could buy and distribute in developing nations vaccines 
for malaria, tuberculosis, HIV, and any infectious disease that 
causes more than 1 million deaths worldwide each year. Such a 
fund could be an important market incentive for private sector 
vaccine research. The President is to report annually to 
Congress regarding the status of negotiations to establish the 
fund, and if established, recommendations for further 
activities.

Sec. 107. World Bank Trust Fund for AIDS Prevention and Eradication

    Section 107 directs the Treasury Secretary to enter into 
negotiations with the World Bank or the International 
Development Association (IDA), member governments, and others 
to create a trust fund that would receive contributions and 
distribute the resources for AIDS programs in countries 
eligible to borrow from IDA. The trust fund would be 
administered by either the World Bank or IDA. Subsection (b) 
authorizes the appropriation of $100 million in fiscal year 
2001 for a U.S. contribution to the trust fund, money that 
would be in addition to other amounts for multilateral or 
bilateral AIDS programs. The Secretary of the Treasury must 
also report annually to the Senate Foreign Relations and 
Banking Committees and the House International Relations and 
Banking Committees on the goals, activities, and effectiveness 
of the trust fund in reducing the spread of AIDS worldwide.

Sec. 108. Negotiations for the Creation of a World Bank Trust Fund for 
        Education of Orphans in Sub-Saharan Africa

    This section requires the Secretary of the Treasury to 
begin negotiations with the World Bank or the International 
Development Association (IDA), member governments, and others 
to create a trust fund that would support primary and secondary 
education programs for orphans in sub-Saharan Africa. 
Subsection (b) authorizes the appropriation of $50 million in 
fiscal year 2001 for a U.S. contribution to the trust fund.

Sec. 109. Coordinated Donor Strategy for Support and Education of 
        Orphans in Sub-Saharan Africa

    This section amends the Foreign Assistance Act of 1961 by 
inserting a new section 131 addressing orphans in Africa. It 
requires the President to coordinate a multidonor strategy to 
support and educate AIDS orphans, and the families, 
communities, and institutions most impacted by the HIV/AIDS 
epidemic in sub-Saharan Africa. A waiver is provided so that 
any U.S. assistance extended under this section can be made 
notwithstanding any other provision of law that would otherwise 
restrict the aid.

Sec. 110. African Crisis Response Initiative and HIV/AIDS Training

    Section 110 addresses the problem of soldiers in African 
militaries who are infected with HIV/AIDS and who may spread 
the disease where civil unrest and war arise. This provision 
requires that U.S. education and classroom training courses for 
African militaries under the African Crisis Response Initiative 
include military-based education on the prevention of the 
spread of HIV/AIDS.

              TITLE II--INTERNATIONAL TUBERCULOSIS CONTROL


Sec. 201. Short Title

    This section designates this title as the International 
Tuberculosis Control Act of 2000.

Sec. 202. Findings

    Tuberculosis, which has been largely controlled in the U.S. 
and elsewhere in the Western world, has re-emerged as a growing 
cause of adult mortality in developing nations. The World Bank 
estimates that about 1.86 million people died of tuberculosis-
related illnesses in 1998 and that one-third of the world's 
population is infected with tuberculosis. Due to the relative 
ease with which it is transmitted, tuberculosis poses a serious 
public health threat to the United States and other areas where 
the disease had been brought under control. Nearly 40 percent 
of U.S. tuberculosis cases are associated with foreign-born 
individuals, leading to the conclusion that it will remain a 
problem for the United States until it is controlled abroad. 
Although the means to control tuberculosis exist, several 
obstacles stand in the way of effective control of the disease: 
lengthy screening, detecting, and treating processes; limited 
funds and trained personnel, the need for unique country-
specific interventions; and the risks posed by bad tuberculosis 
programs. Therefore, a well designed and coordinated global 
effort could make a significant contribution in combating this 
growing public health problem.

Sec. 203. Assistance for Tuberculosis Prevention, Treatment, Control, 
        and Elimination

    This section amends the Foreign Assistance Act of 1961 by 
adding new language stating Congressional expectation that 
USAID will coordinate with various health organizations to 
develop and implement a comprehensive tuberculosis control 
program. Congress further anticipates that USAID will establish 
as goals, to be achieved by December 31, 2010, the detection of 
70 percent of infectious tuberculosis cases, and the cure of at 
least 85 percent of such cases, in countries where the Agency 
has established programs. Included is the authorization of $60 
million in fiscal year 2001 to carry out the purposes of this 
subtitle.

                           III. Cost Estimate

    In accordance with rule XXVI, paragraph 11(a) of the 
Standing Rules of the Senate, the Committee provides the 
following estimate of the cost of this legislation prepared by 
the Congressional Budget Office:

                                     U.S. Congress,
                               Congressional Budget Office,
                                     Washington, DC, June 29, 2000.

Hon. Jesse Helms, Chairman,
U.S. Senate,
Committee on Foreign Relations,
Washington, DC.

    Dear Mr. Chairman:
    The Congressional Budget Office has prepared the enclosed 
cost estimate for the Global AIDS and Tuberculosis Relief Act 
of 2000.
    If you wish further details on this estimate, we will be 
pleased to provide them. The CBO staff contact is Joseph C. 
Whitehill.
            Sincerely,
                                  Dan L. Crippen, Director.

Enclosure.

               CONGRESSIONAL BUDGET OFFICE COST ESTIMATE

Summary
    The Global AIDS and Tuberculosis Relief Act of 2000 would 
authorize appropriations of $570 million in 2001. The bill 
would authorize $150 million for contributions to new trust 
funds within the World Bank to help developing countries fight 
HIV/AIDS and to educate orphans in sub-Saharan Africa. It would 
authorize $420 million for bilateral and multilateral programs 
to fight infectious diseases. Assuming the appropriation of the 
authorized amounts, CBO estimates that implementing the bill 
would cost $505 million over the 2001-2005 period. Because it 
would not affect direct spending or receipts, the bill would 
not be subject to pay-as-you-go procedures.
    The Global AIDS and Tuberculosis Relief Act of 2000 
contains no intergovernmental or private-sector mandates as 
defined in the Unfunded Mandates Reform Act (UMRA) and would 
not affect the budgets of state, local, or tribal governments.
Estimated Cost to the Federal Government
    The estimated budgetary impact of the bill is shown in the 
following table. The costs of this legislation fall within 
budget function 150 (international affairs).

                    Spending Subject to Appropriation
                [By fiscal year, in millions of dollars]
------------------------------------------------------------------------
                                 2000   2001   2002   2003   2004   2005
------------------------------------------------------------------------
Spending Under Current Law for
 Infectious Disease Programs:
  Budget Authority \1\........    210      0      0      0      0      0
  Estimated Outlays...........    136    156     53     27     18     13
Proposed Changes:
  Estimated Authorization           0    570      0      0      0      0
   Level......................
  Estimated Outlays...........      0     92    207     96     64     46
Spending Under the Bill for
 Infectious Disease Programs:
  Estimated Authorization         210    570      0      0      0      0
   Level \1\..................
  Estimated Outlays...........    136    248    260    123     82     59
------------------------------------------------------------------------
\1\ The 2000 level is the amount appropriated for that year.

Basis of Estimate
    The bill would authorize the appropriation of $570 million 
in 2001 for bilateral and multilateral programs to fight AIDS 
and other infectious diseases and to assist orphans. For this 
estimate, CBO assumes appropriation of the authorized amounts 
by or near the start of fiscal year 2001.
    World Bank Trust Funds. The bill would authorize the 
Secretary of the Treasury to negotiate with the World Bank and 
other donor countries to create two new trust funds within the 
bank. The first trust fund would provide grants to countries 
eligible to borrow from the bank to help them deal with the 
HIV/AIDS epidemic. The second trust fund would support primary 
and secondary education programs for orphans in sub-Saharan 
Africa. The bill would authorize the appropriation in 2001 of 
$100 million for a contribution to the HIV/AIDS fund and $50 
million for a contribution to the sub-Saharan Africa fund.
    Based on experience with other facilities operated by 
multilateral development banks, CBO estimates that it would 
take the bank and donor community more than one year to 
organize the operations of the trust fund and to begin making 
grants. CBO assumes that project selection and subsequent 
grants would augment lending by the bank, thus limiting 
administrative overhead. We also assume that the appropriated 
amounts would be provided to the trust fund as a letter of 
credit that would be drawn upon as needed to finance the 
grants, thus spreading outlays over a number of years. Using 
those assumptions, CBO estimates that approximately 75 percent 
of the authorized amounts would be disbursed over the next five 
years. CBO also estimates that the costs of negotiations and 
reporting requirements would be negligible.
    Other Programs. The bill would also authorize $420 million 
to fight infectious diseases--$360 million for bilateral 
assistance to fight HIV/AIDS and tuberculosis, $50 million for 
a contribution to the Global Alliance for Vaccine Initiative, 
and $10 million for a contribution to the International AIDS 
Vaccine Initiative. Up to $21 million of the authorized amounts 
would be available for administrative expenses. Based on 
historical spending patterns for similar programs, CBO 
estimates that appropriation of the authorized amounts would 
result in outlays of $391 million over the next five years.
Pay-As-You-Go Considerations
    None.
Previous CBO Estimate
    On April 6, 2000, CBO transmitted a cost estimate for S. 
2382, the Technical Assistance, Trade Promotion, and Anti-
Corruption Act of 2000. This bill contains a subset of the 
provisions in the earlier bill, and the cost estimates for 
those provisions are the same.
Intergovernmental and Private-Sector Impact
    The Global AIDS and Tuberculosis Relief Act of 2000 
contains no intergovernmental or private-sector mandates as 
defined in UMRA and would not affect the budgets of state, 
local, or tribal governments.
Estimate Prepared By
    Federal costs: Joseph C. Whitehill. Impact on state, local, 
and tribal governments: Leo Lex. Impact on the private sector: 
Lauren Marks.
Estimate Approved By
    Peter H. Fontaine, Deputy Assistant Director for Budget 
Analysis.

                  IV. Evaluation of Regulatory Impact

    In accordance with rule XXVI, paragraph 11(b) of the 
Standing Rules of the Senate, the Committee has concluded that 
there is no regulatory impact from this legislation.

                       V. Changes in Existing Law

    In compliance with paragraph 12 rule XXVI of the Standing 
Rules of the Senate, changes in existing law made by the bill, 
as reported, are shown as follows (existing law proposed to be 
omitted is enclosed in black brackets, new matter is printed in 
italic, existing law in which no change is proposed is shown in 
roman):

Foreign Assistance Act of 1961

           *       *       *       *       *       *       *


    Sec. 104. Population and Health.--(a) Findings. * * *
    (c) Assistance for Health and Disease Prevention.--(1) * * 
*
  (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, 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 
        in scale 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 
providing--
          (i) primary prevention and education;
          (ii) voluntary testing and counseling;
          (iii) medications to prevent the transmission of HIV 
        and AIDS 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 fiscal year 2001 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 subparagraph may be 
made available notwithstanding any other provision of law.
  (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 $21,000,000 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.
  (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 fiscal year 2001 to be used to carry out this 
paragraph. Funds appropriated under this subparagraph are 
authorized to remain available until expended.

           *       *       *       *       *       *       *


SEC. 131. 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/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) Authority.--Assistance made available under this section 
may be made available notwithstanding any other provision of 
law.
  (d) Definition.--In this section, the term ``HIV/AIDS'' 
means, with respect to an individual, an individual who is 
infected with--
          (1) the human immunodeficiency virus (HIV); or
          (2) HIV and the acquired immune deficiency virus 
        (AIDS).

           *       *       *       *       *       *       *

    Sec. 302. Authorization.--(a) * * *
    [(j)  In addition to amounts otherwise available under this 
section for such purposes, there are authorized to be 
appropriated to the President $3,000,000 for fiscal year 1989 
to be available only for United States contributions to 
multilateral and regional drug abuse control programs. Of the 
amount authorized to be appropriated by this subsection--
          [(1) $2,000,000 shall be for a United States 
        contribution to the United Nations Fund for Drug Abuse 
        Control;
          [(2) $600,000 shall be for the Organization of 
        American States (OAS) Inter-American Drug Abuse Control 
        Commission (CICAD) Legal Development Project, except 
        that the proportion which such amount bears to the 
        total amount of contributions to this specific project 
        may not exceed the proportion which the United States 
        contribution to the budget of the Organization of 
        American States for that fiscal year bears to the total 
        contributions to the budget of the Organization of 
        American States for that fiscal year; and
          [(3) $400,000 shall be for the Organization of 
        American States (OAS) Inter-American Drug Abuse Control 
        Commission (CICAD) Law Enforcement Training Project, 
        except that the proportion which such amount bears to 
        the total amount of contributions to this specific 
        project may not exceed the proportion which the United 
        States contribution to the budget of the Organization 
        of American States for that fiscal year bears to the 
        total contributions to the budget of the Organization 
        of American States for that fiscal year.]
  (j) In addition to amounts otherwise available under this 
section, there is authorized to be appropriated to the 
President $50,000,000 for fiscal year 2001 to be available only 
for United States contributions to the Global Alliance for 
Vaccines and Immunizations.
  (k) In addition to amounts otherwise available under this 
section, there is authorized to be appropriated to the 
President $10,000,000 for fiscal year 2001 to be available only 
for United States contributions to the International AIDS 
Vaccine Initiative.

           *       *       *       *       *       *       *


                CHAPTER 10--DEVELOPMENT FUND FOR AFRICA

  Sec. 496. Long-Term Development Assistance for Sub-Saharan 
Africa.--(a) * * *

           *       *       *       *       *       *       *

  (i) Critical Sectoral Priorities.-- * * *
          (1) Agricultural production and natural resources.--

           *       *       *       *       *       *       *

          (2) Health.--Improving health conditions, with 
        special emphasis on meeting the health needs of mothers 
        and children (including displaced children) through the 
        establishment of primary health care systems that give 
        priority to preventive health and that will be 
        ultimately self-sustaining. 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.

                                  
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