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108th CONGRESS
  1st Session
                                H. R. 1857

   To authorize assistance to combat the growing HIV/AIDS problem in 
           countries in sub-Saharan Africa and the Caribbean.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                             April 29, 2003

   Mr. Hastings of Florida introduced the following bill; which was 
          referred to the Committee on International Relations

_______________________________________________________________________

                                 A BILL


 
   To authorize assistance to combat the growing HIV/AIDS problem in 
           countries in sub-Saharan Africa and the Caribbean.

    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 ``Humanitarian Assistance to Combat 
HIV/AIDS in sub-Saharan Africa and the Caribbean and National Security 
Act of 2003''.

SEC. 2. FINDINGS.

     Congress makes the following findings:
            (1) The National Security Strategy of the United States, 
        dated September 17, 2002, states: ``[I]n Africa, promise and 
        opportunity sit side-by-side with disease, war and desperate 
        poverty. This threatens both a core value of the United States 
        preserving human dignity and our strategic priority combating 
        global terror. American interests and American principles, 
        therefore, lead in the same direction: we will work with others 
        for an African continent that lives in liberty, peace, and 
        growing prosperity.''.
            (2) On March 19, 2002, the Director of Central Intelligence 
        testified before Congress that ``[T]he chronic problems of sub-
        Saharan Africa make it, too, fertile ground for direct and 
        indirect threats to United States interests. Governments 
        without accountability and natural disasters have left Africa 
        with the highest concentration of human misery in the world.''.
            (3) Sub-Saharan Africa has been far more severely affected 
        by HIV/AIDS than any other part of the world. In fact, AIDS has 
        surpassed malaria as the leading cause of death in sub-Saharan 
        Africa, and it kills many times more people than Africa's armed 
        conflicts.
            (4) Africa, where an estimated 3,500,000 people were newly 
        infected with HIV in 2002, has approximately 10 percent of the 
        world's population but more than 70 percent of the worldwide 
        total of people infected with HIV.
            (5) In November 2002, the Joint United Nations Programme on 
        HIV/AIDS (UNAIDS) reported that in 2002, 29,400,000 people were 
        living with HIV/AIDS in sub-Saharan Africa, an increase from 
        28,500,000 people in 2001.
            (6) At the end of 2001, an estimated 21,500,000 Africans 
        had lost their lives to AIDS, including an estimated 2,200,000 
        individuals who died in that year. UNAIDS estimates that by 
        2020, an additional 55,000,000 Africans will lose their lives 
        to the epidemic.
            (7) The HIV/AIDS epidemic in Africa is having a much 
        greater impact on children than is the case in other parts of 
        the world.
            (8) According to UNAIDS, more than 600,000 African infants 
        become infected with HIV each year through mother-to-child 
        transmission, either at birth or through breast-feeding. These 
        children have short life expectancies, and the number currently 
        alive may be about 1,000,000 children.
            (9) In 2001, an estimated 11,000,000 children who became 
        orphans by AIDS were living in Africa.
            (10) Because of the stigma attached to AIDS, children who 
        become orphans by AIDS are at high risk for being malnourished, 
        abused, and denied an education.
            (11) According to UNAIDS, women make up an estimated 58 
        percent of the HIV-positive adult population in sub-Saharan 
        Africa, as compared to 50 percent of the HIV-positive adult 
        population worldwide.
            (12) Young women are particularly at risk. In 2001, an 
        estimated 6 to 11 percent of African women aged 15 to 24 were 
        HIV-positive, compared to 3 to 6 percent of young men.
            (13)(A) The HIV-infection rate among adults is 
        approximately 8.8 percent in Africa, compared with 1.2 percent 
        worldwide. The HIV/AIDS epidemic in sub-Saharan Africa is a 
        major component of this African crisis.
            (B) In 7 sub-Saharan African countries, 20 percent or more 
        of the adult population is infected with HIV, and the rate has 
        reached 38.8 percent in Botswana.
            (C) Moreover, in Cameroon, a West African country, the 
        adult HIV-infection rate has increased from 4.7 percent in 1996 
        to 11.8 percent in 2001.
            (D) In Nigeria, with a population that exceeds 125,000,000, 
        an estimated 5.8 percent of adults were HIV-positive in 2001, 
        and infection rates in some areas of Nigeria have reached 
        levels seen in neighboring Cameroon.
            (14) Nongovernmental organizations working in Africa, donor 
        governments, and African governments have responded to the HIV/
        AIDS epidemic primarily by attempting to reduce the number of 
        new HIV infections, and to some degree, by trying to ameliorate 
        the damage done by AIDS to families, societies, and economies.
            (15)(A) A 1999 United Nations study found that community-
        based organizations, sometimes with the support of 
        nongovernmental organizations, have emerged to supply 
        additional labor, home care for the sick, house repair, and 
        other services to AIDS-afflicted families.
            (B) Programs and projects aimed at combating the epidemic 
        typically provide information on how HIV is spread, and on how 
        it can be avoided, through the media, posters, lectures, and 
        skits. AIDS awareness programs can be found in many African 
        schools and increasingly in the workplace, where employers are 
        recognizing their interest in reducing the HIV-infection rate 
        among their employees.
            (16) Public-private partnerships have also become an 
        important vehicle for responding to the HIV/AIDS pandemic in 
        Africa.
            (17)(A) The United States Agency for International 
        Development estimates that in fiscal year 2000, all donors and 
        lending agencies, together with African governments, spent 
        approximately $500,000,000 in combating HIV/AIDS, but donors 
        have committed to increasing this amount.
            (B) On July 23, 2000, leaders at the G-8 world economic 
        summit in Okinawa, Japan, pledged to reduce the number of young 
        people infected with the HIV virus by 25 percent.
            (18) The World Health Organization estimates that a pledge 
        by the G-8 countries to combat malaria and tuberculosis, and 
        reduce the HIV virus in Africa by 25 percent, would cost at 
        least $5,000,000,000 per year for 5 years. The World Bank 
        launched its Multi-Country HIV/AIDS Program (MAP) for Africa in 
        September 2000, and a World Bank official said in October 2002 
        that to date, $1,000,000,000 had been committed.
            (19) On December 9, 2001, Peter Piot, Executive Director of 
        UNAIDS, told an international AIDS conference in Burkina Faso 
        that assistance to fight HIV/AIDS in sub-Saharan Africa should 
        be increased ``many-fold'', and that the region requires 
        $5,000,000,000 per year to confront the HIV/AIDS pandemic.
            (20) While the AIDS epidemic in Caribbean countries does 
        not compare to the severity of the epidemic in Africa, there 
        are an estimated 420,000 people living with AIDS in Caribbean 
        countries. Moreover, the HIV/AIDS adult prevalence rate in 
        several countries in the Caribbean is among the highest outside 
        of sub-Saharan Africa.
            (21) Caribbean countries with the highest prevalence of HIV 
        infection rates are Haiti and the Bahamas, with adult HIV 
        infection rates at more than 4 percent. Overall, an estimated 1 
        out of 50 people in Caribbean countries is infected with HIV. 
        Haiti and the Dominican Republic, with a combined 340,000 
        adults and children living with HIV/AIDS, account for 
        approximately 87 percent of the infected population of 
        Caribbean countries. As noted by the United States Agency for 
        International Development, Haiti's poverty, civil conflict, and 
        unstable governance have contributed to the rapid spread of 
        AIDS. In some urban areas of Haiti, HIV infection rates are at 
        more than 10 percent of the population.
            (22) In Caribbean countries, access to treatment and care 
        is non-existent for many infected with HIV. Nevertheless, many 
        projects demonstrate that even in severely impoverished 
        countries with little health infrastructure, there can be 
        sustained treatment for people with HIV/AIDS.

SEC. 3. SENSE OF CONGRESS.

     It is the sense of Congress that--
            (1) effectively addressing the HIV/AIDS problem in 
        countries in sub-Saharan Africa and the Caribbean is a moral 
        issue of the greatest magnitude and is in the national security 
        interest of the United States; and
            (2) the President should enter into direct talks with the 
        governments of other member countries of the G-8 and member 
        countries of the European Union to increase the amount of 
        financial support to combat the HIV/AIDS pandemic in sub-
        Saharan Africa and the Caribbean.

SEC. 4. GRANTS TO COMBAT HIV/AIDS IN SUB-SAHARAN AFRICA AND CARIBBEAN 
              COUNTRIES.

     The Administrator of the United States Agency for International 
Development is authorized to award grants to nongovernmental 
organizations for the prevention, treatment, and control of HIV/AIDS in 
countries in sub-Saharan Africa and Caribbean countries, including by 
expanding activities to prevent the mother-to-child transmission of HIV 
by providing treatment, medical care, and support services to HIV-
infected parents and their children. In carrying out the preceding 
sentence, it is the sense of Congress that the Secretary of Health and 
Human Services, acting through the Director of the Centers for Disease 
Control and Prevention, should provide appropriate medical and 
technical expertise to the Administrator and recipient governments.

SEC. 5. APPOINTMENT OF HEALTH OFFICERS TO UNITED STATES EMBASSIES IN 
              SUB-SAHARAN AFRICA AND THE CARIBBEAN.

    The Secretary of State, in conjunction with the Secretary of Health 
and Human Services, is authorized to appoint to the country team in 
each United States embassy in sub-Saharan Africa and the Caribbean a 
health officer to advise the United States Ambassador and assist in 
coordination of the effort to combat HIV/AIDS with local governments.

SEC. 6. AUTHORIZATION OF APPROPRIATIONS.

    (a) In General.--There are authorized to be appropriated to carry 
out this Act $500,000,000 for each of the fiscal years 2004 through 
2008.
    (b) Availability.--Amounts appropriated pursuant to the 
authorization of appropriations under subsection (a) are authorized to 
remain available until expended.

SEC. 7. DEFINITIONS.

     In this Act:
            (1) AIDS.--The term ``AIDS'' means acquired immune 
        deficiency syndrome.
            (2) Caribbean countries.--The term ``Caribbean countries'' 
        means the countries described in section 212(b) of the 
        Caribbean Basin Economic Recovery Act (19 U.S.C. 2702(b)).
            (3) HIV.--The term ``HIV'' means the human immunodeficiency 
        virus, the pathogen that causes AIDS.
    (4) HIV/AIDS.--The term ``HIV/AIDS'' means, with respect to an 
individual, an individual who is infected with HIV or living with AIDS.
            (5) Countries in sub-saharan africa.--The term ``countries 
        in sub-Saharan Africa'' has the meaning given such term in 
        section 107 of the African Growth and Opportunity Act (19 
        U.S.C. 3706).
                                 <all>

Pages: 1

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