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H.R. 351 (ih) To prohibit the Secretary of Health and Human Services from treating any Medicaid-related funds recovered as part of State litigation from one or more tobacco companies as an overpayment under the Medicaid Program. [Introduced in House] %%Fi...


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                                                 Union Calendar No. 298
106th CONGRESS
  2d Session
                                H. R. 3519

                          [Report No. 106-548]

  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.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                            January 24, 2000

  Mr. Leach introduced the following bill; which was referred to the 
              Committee on Banking and Financial Services

                             March 28, 2000

 Additional sponsors: Ms. Lee, Ms. Millender-McDonald, Mr. Gutierrez, 
   Ms. Roybal-Allard, Mr. Evans, Mr. Hall of Ohio, Mr. Gonzalez, Ms. 
DeLauro, Mr. Rush, Mr. Houghton, Mr. Filner, Ms. Waters, Mr. Frost, Mr. 
LaFalce, Mr. Cummings, Mr. Nadler, Ms. Slaughter, Ms. Schakowsky, Mrs. 
Morella, Mr. Wexler, Ms. McKinney, Mrs. Jones of Ohio, Ms. Carson, Mr. 
   Castle, Mr. Bentsen, Ms. Woolsey, Mr. Watt of North Carolina, Ms. 
                         Norton, and Mr. Rangel

                             March 28, 2000

  Reported with an amendment, committed to the Committee of the Whole 
       House on the State of the Union, and ordered to be printed
 [Strike out all after the enacting clause and insert the part printed 
                               in italic]
[For text of introduced bill, see copy of bill as introduced on January 
                               24, 2000]

_______________________________________________________________________

                                 A BILL


 
  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.

    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 ``World Bank AIDS Marshall Plan Trust 
Fund Act''.

SEC. 2. FINDINGS AND PURPOSES.

    (a) Findings.--The Congress finds the following:
            (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), 33,600,000 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, 3,600,000 have died from AIDS, 1,200,000 are living 
        with the disease; and in one year alone--1999--an estimated 
        570,000 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 23,300,000--roughly 70 
        percent--of the world's HIV/AIDS cases.
            (5) Worldwide, there have already been an estimated 
        16,300,000 deaths because of HIV/AIDS, of which 13,700,000--
        over 80 percent--occurred in Sub-Saharan Africa.
            (6) According to testimony by the Office of National AIDS 
        Policy, an entire generation of children in Africa is in 
        jeopardy, with one-fifth to one-third of all children in some 
        countries already orphaned and the figure estimated to rise to 
        40,000,000 by 2010.
            (7) 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.''
            (8) A 1999 Bureau of the Census report states that the 
        average life expectancy in the Republic of Botswana, the 
        Republic of Zimbabwe, the Kingdom of Swaziland, the Republic of 
        Malawi, and the Republic of Zambia has decreased from 
        approximately age 65 to approximately age 40--the lowest life 
        expectancy in the world--due to high mortality rates from HIV/
        AIDS.
            (9) A January 2000 unclassified 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.
            (10) 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.
            (11) The HIV/AIDS epidemic is of increasing concern in 
        other regions of the world with UNAIDS reporting, for example, 
        that there are 6 million 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.
            (12) Despite the grim 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.
            (13) AIDS, like all diseases, knows no boundaries, and 
        there is no certitude that the scale of the problem in one 
        continent can be contained within that region.
            (14) According to a 1999 study prepared by UNAIDS and the 
        Francois-Xavier Bagnoud Center for Health and Human Rights at 
        the Harvard School of Public Health, HIV/AIDS is spreading 
        three times faster than funding available to control the 
        disease.
            (15) The United Nations Secretary General has stated ``[n]o 
        company and no government can take on the challenge of AIDS 
        alone,'' and that what is needed is a new approach to public 
        health--combining all available resources, public and private, 
        local and global.''
            (16) The World Bank, declaring AIDS not just a public 
        health problem but ``the foremost and fastest-growing threat to 
        development'' in Africa, has launched a new strategy for HIV/
        AIDS in Africa, declaring it a top priority for the Bank on 
        that continent.
            (17) The World Bank estimates that for Africa alone 
        $1,000,000,000 to $2,300,000,000 annually is needed for 
prevention in contrast to the approximately $300,000,000 a year in 
official assistance currently available for HIV/AIDS in Africa.
            (18) 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 Act are to prevent the spread 
of HIV/AIDS and promote its eradication, prevent human suffering, and 
to mitigate the devastating impact of the disease on economic and human 
development, social stability, and security in the developing world, 
through the creation of a trust fund which is designed to--
            (1) work with governments, civil society, non-governmental 
        organizations, the Joint United Nations Program on HIV/AIDS 
        (UNAIDS), the International Partnership Against AIDS in Africa, 
        other international organizations, donor agencies, and the 
        private sector to intensify action against the HIV/AIDS 
        epidemic and to support essential field work in the most 
        affected countries to assist in the development of AIDS 
        vaccines; and
            (2) seek to leverage financial commitments by the United 
        States in order to mobilize additional resources from other 
        donors, the private sector, nongovernmental organizations, and 
        recipient countries to combat the spread of HIV/AIDS.

 TITLE I--NEGOTIATIONS FOR THE CREATION OF A WORLD BANK AIDS TRUST FUND

SEC. 101. TRUST FUND TO ASSIST IN HIV/AIDS PREVENTION, CARE AND 
              TREATMENT, AND ERADICATION.

    The Secretary of the Treasury shall seek to enter into negotiations 
with the International Bank for Reconstruction and Development or the 
International Development Association, and with the member nations of 
such institutions and with other interested parties for the creation of 
a trust fund which would be authorized to solicit and accept 
contributions from governments, the private sector, and nongovernmental 
entities of all kinds and use the contributions to address the HIV/AIDS 
epidemic in countries eligible to borrow from such institutions, as 
follows:
            (1) Program objectives.--The trust fund would 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 affordable drugs. In carrying 
        out this objective, the trust fund would 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.
            (2) Priority.--In providing such grants, the trust fund 
        would give priority to countries that have the highest HIV/AIDS 
        prevalence rate or are at risk of having a high HIV/AIDS 
        prevalence rate, and that have or agree to carry out a national 
        HIV/AIDS program which--
                    (A) has a government commitment at the highest 
                level and multiple partnerships with civil society and 
                the private sector;
                    (B) invests early in effective prevention efforts;
                    (C) requires cooperation and collaboration among 
                many different groups and sectors, including those who 
                are most affected by the epidemic, religious and 
                community leaders, nongovernmental organizations, 
                researchers and health professionals, and the private 
                sector;
                    (D) is decentralized and uses participatory 
                approaches to bring prevention care programs to 
                national scale; and
                    (E) is characterized by community participation in 
                government policymaking as well as design and 
                implementation of the program, including implementation 
                of such programs by people living with HIV/AIDS, 
                nongovernmental organizations, civil society, and the 
                private sector.
            (3) Governance.--
                    (A) In general.--The trust fund would be 
                administered as a trust fund of the International Bank 
                for Reconstruction and Development. Subject to general 
                policy guidance from the President of the United States 
                and representatives of the other donors to the trust 
                fund, the Trustee would be responsible for managing the 
                day-to-day operations of the trust fund.
                    (B) Selection of projects and recipients.--In 
                consultation with the President and other donors to the 
trust fund, the Trustee would establish criteria, that have been agreed 
on by the donors, for the selection of projects to receive support from 
the trust fund, standards and criteria regarding qualifications of 
recipients of such support, as well as such rules and procedures as 
would be necessary for cost-effective management of the trust fund. The 
trust fund would not make grants for the purpose of project development 
associated with bilateral or multilateral development bank loans.
                    (C) Transparency of operations.--The Trustee shall 
                ensure full and prompt public disclosure of the 
                proposed objectives, financial organization, and 
                operations of the trust fund.
                    (D) Advisory board.--
                            (i) Appointment.--The President of the 
                        United States and representatives of other 
                        participating donors to the trust fund would 
                        establish an Advisory Board, and appoint to the 
                        Advisory Board renowned and distinguished 
                        international leaders who have demonstrated 
                        integrity and knowledge of issues relating to 
                        development, health care (especially HIV/AIDS), 
                        and Africa.
                            (ii) Duties.--The Advisory Board would, in 
                        consultation with other international experts 
                        in related fields (including scientists, 
                        researchers, and doctors), advise and provide 
                        guidance for the trust fund on the development 
                        and implementation of the projects receiving 
                        support from the trust fund. Once the Advisory 
                        Board is established, the Secretary of the 
                        Treasury shall ensure that the Trustee provides 
                        the Advisory Board complete access to all 
                        information and documents of the trust fund 
                        necessary to the effective functioning of the 
                        Advisory Board.

            TITLE II--UNITED STATES FINANCIAL PARTICIPATION

SEC. 201. LIMITATIONS ON AUTHORIZATION OF APPROPRIATIONS.

    In addition to any other funds authorized to be appropriated for 
multilateral or bilateral programs related to AIDS or economic 
development, there are authorized to be appropriated to the Secretary 
of the Treasury $200,000,000 for each of fiscal years 2001 through 2005 
for payment to the trust fund established as a result of negotiations 
entered into pursuant to section 101.

                           TITLE III--REPORTS

SEC. 301. REPORTS TO THE CONGRESS.

    (a) Annual Reports.--Not later than 1 year after the date of the 
enactment of this Act, and annually thereafter for the duration of the 
trust fund established pursuant to section 101, the Secretary of the 
Treasury shall submit to the appropriate committees of the Congress a 
written report on the trust fund, the goals of the trust fund, the 
programs, projects, and activities, including any vaccination 
approaches, supported by the trust fund, and the effectiveness of such 
programs, projects, and activities in reducing the worldwide spread of 
AIDS.
    (b) Appropriate Committees Defined.--In subsection (a), the term 
``appropriate committees'' means the Committees on Appropriations, on 
International Relations, and on Banking and Financial Services of the 
House of Representatives and the Committees on Appropriations, on 
Foreign Relations, and on Banking, Housing, and Urban Affairs of the 

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