Home > 106th Congressional Bills > H.R. 3519 (ih) 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. [Introduced in House] %%F...

H.R. 3519 (ih) 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. [Introduced in House] %%F...

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                       One Hundred Sixth Congress

                                 of the

                        United States of America

                          AT THE SECOND SESSION

           Begun and held at the City of Washington on Monday,
             the twenty-fourth day of January, two thousand

                                 An Act

   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,


    This Act may be cited as the ``Global AIDS and Tuberculosis Relief 
Act of 2000''.


    The table of contents for this Act is as follows:

Sec. 1. Short title.
Sec. 2. Table of contents.


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.


Sec. 201. Short title.
Sec. 202. Findings.
Sec. 203. Assistance for tuberculosis prevention, treatment, control, 
          and elimination.


Sec. 301. Effective program oversight.
Sec. 302. Termination expenses.



    This title may be cited as the ``Global AIDS Research and Relief 
Act of 2000''.


    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.
        (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 


    (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 1 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 
        (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 2 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


    (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 
    ``(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 
        ``(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 
    ``(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 
        ``(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 
    ``(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)) 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.''.

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