Assistance to combat HIV/AIDS

Congress recognizes that the alarming spread of HIV/AIDS in countries in sub-Saharan Africa, the Caribbean, Central Asia, Eastern Europe, Latin America and other developing countries is a major global health, national security, development, and humanitarian crisis. It is a major objective of the foreign assistance program of the United States to provide assistance for the prevention and treatment of HIV/AIDS and the care of those affected by the disease. It is the policy objective of the United States, by 2013, to— assist partner countries to— support— The United States and other countries with the sufficient capacity should provide assistance to countries in sub-Saharan Africa, the Caribbean, Central Asia, Eastern Europe, and Latin America, and other countries and regions confronting HIV/AIDS epidemics in a coordinated global strategy to help address generalized and concentrated epidemics through HIV/AIDS prevention, treatment, care, monitoring and evaluation, and related activities. The United States Government’s response to the global HIV/AIDS pandemic and the Government’s efforts to help countries assume leadership of sustainable campaigns to combat their local epidemics should place high priority on— Consistent with section 2151b(c) of this title, the President is authorized to furnish assistance, on such terms and conditions as the President may determine, for HIV/AIDS, including to prevent, treat, and monitor HIV/AIDS, and carry out related activities, in countries in sub-Saharan Africa, the Caribbean, Central Asia, Eastern Europe, Latin America, and other countries and areas, particularly with respect to refugee populations or those in postconflict settings in such countries and areas with significant or increasing HIV incidence rates. It is the sense of Congress that the President should provide an appropriate level of assistance under paragraph (1) through nongovernmental organizations (including faith-based and community-based organizations) in countries in sub-Saharan Africa, the Caribbean, Central Asia, Eastern Europe, Latin America, and other countries and areas affected by the HIV/AIDS pandemic, particularly with respect to refugee populations or those in post-conflict settings in such countries and areas with significant or increasing HIV incidence rates..22 So in original. The President shall coordinate the provision of assistance under paragraph (1) with the provision of related assistance by the Joint United Nations Programme on HIV/AIDS (UNAIDS), the United Nations Children’s Fund (UNICEF), the World Health Organization (WHO), the United Nations Development Programme (UNDP), the Global Fund to Fight AIDS, Tuberculosis and Malaria and other appropriate international organizations (such as the International Bank for Reconstruction and Development), relevant regional multilateral development institutions, national, state, and local governments of partner countries, other international actors,,2 appropriate governmental and nongovernmental organizations, and relevant executive branch agencies within the framework of the principles of the Three Ones. Assistance provided under subsection (c) shall, to the maximum extent practicable, be used to carry out the following activities: Prevention of HIV/AIDS through activities including— assistance to— assistance for counseling, testing, treatment, care, and support programs, including— counseling to prevent sexual transmission of HIV, including— The treatment and care of individuals with HIV/AIDS, including— The monitoring of programs, projects, and activities carried out pursuant to paragraphs (1) through (3), including— carrying out and expanding program monitoring, impact evaluation research and analysis, and operations research and disseminating data and findings through mechanisms to be developed by the Coordinator of United States Government Activities to Combat HIV/AIDS Globally, in coordination with the Director of the Centers for Disease Control, in order to— establishing appropriate systems to— The procurement of HIV/AIDS pharmaceuticals, antiviral therapies, and other appropriate medicines, including medicines to treat opportunistic infections. Mechanisms to ensure that such HIV/AIDS pharmaceuticals, antiretroviral therapies, and other appropriate medicines are quality-controlled and sustainably supplied. Subject to subparagraph (B), mechanisms to ensure that safe and effective pharmaceuticals, including antiretrovirals and medicines to treat opportunistic infections, are purchased at the lowest possible price at which such pharmaceuticals may be obtained in sufficient quantity on the world market, provided that such pharmaceuticals are approved, tentatively approved, or otherwise authorized for use by— The distribution of such HIV/AIDS pharmaceuticals, antiviral therapies, and other appropriate medicines (including medicines to treat opportunistic infections) to qualified national, regional, or local organizations for the treatment of individuals with HIV/AIDS in accordance with appropriate HIV/AIDS testing and monitoring requirements and treatment protocols and for the prevention of mother-to-child transmission of the HIV infection. The conduct of related activities, including— coordinated or referred activities to— ameliorate the adverse social and economic costs often affecting AIDS-impacted families and communities through the direct provision, as necessary, or through the referral, if possible, of support services, including— coordinated or referred activities to link programs addressing HIV/AIDS with programs addressing gender-based violence in areas of significant HIV prevalence to assist countries in the development and enforcement of women’s health, children’s health, and HIV/AIDS laws and policies that— coordinated or referred activities to— activities to— The establishment and operation of public-private partnership entities within countries in sub-Saharan Africa, the Caribbean, and other countries affected by the HIV/AIDS pandemic that are dedicated to supporting the national strategy of such countries regarding the prevention, treatment, and monitoring of HIV/AIDS. Each such public-private partnership should— The development of compacts or framework agreements, tailored to local circumstances, with national governments or regional partnerships in countries with significant HIV/AIDS burdens to promote host government commitment to deeper integration of HIV/AIDS services into health systems, contribute to health systems overall, and enhance sustainability, including— Congress makes the following findings: Compacts on HIV/AIDS authorized under subsection (d)(8) shall include the following elements: Compacts whose primary purpose is to provide direct services to combat HIV/AIDS are to be made between— countries or regions— Compacts whose primary purpose is to provide limited technical assistance to a country or region connected to services provided within the country or region— shall be made only upon prior notification to Congress— Compacts shall include provisions to— Compacts shall contain— consideration of the methods by which the compact is intended to— consideration of the methods by which the compact will— Amounts made available for compacts described in subparagraphs (A) and (B) shall be subject to the inclusion of— In entering into a compact on HIV/AIDS authorized under subsection (d)(8), the Coordinator of United States Government Activities to Combat HIV/AIDS Globally shall seek to ensure that the government of a country— Not later than 10 days after entering into a compact authorized under subsection (d)(8), the Global AIDS Coordinator shall— submit a report containing a detailed summary of the compact and a copy of the text of the compact to— Not later than February 15, 2014, and annually thereafter, the President shall submit to the Committee on Foreign Relations of the Senate and the Committee on Foreign Affairs of the House of Representatives a report in an open, machine readable format, on the implementation of this section for the prior fiscal year. The report due not later than February 15, 2014, shall include the elements required by law prior to the enactment of the PEPFAR Stewardship and Oversight Act of 2013. Each report submitted after February 15, 2014, shall include the following: A description based on internationally available data, and where practicable high-quality country-based data, of the total global burden and need for HIV/AIDS prevention, treatment, and care, including— Reporting on annual targets across prevention, treatment, and care interventions in partner countries, including— a description of how those targets are designed to— national targets across prevention, treatment, and care that are— bilateral programmatic targets across prevention, treatment, and care, including— An assessment and quantification of progress over the reporting period toward achieving the targets set forth in subparagraph (B), including— the number, by partner country, of persons on HIV treatment, including specifically— antiretroviral treatment program retention rates by partner country, including— A description of partner country and United States-funded HIV/AIDS prevention programs and policies, including— an assessment by country of progress towards targets set forth in subparagraph (B), with a detailed description of the metrics used to assess— A description of the indicators and milestones used to assess effective, strategic, and appropriately timed country ownership, including— A description, globally and by partner country, of specific efforts to achieve and incentivize greater programmatic and cost effectiveness, including— A description of partnership framework agreements with countries, and regions where applicable, including— the objectives and structure of partnership framework agreements with countries, including— A description, globally and by country, of specific efforts to address co-infections and co-morbidities of HIV/AIDS, including— Not later than February 1, 2014, the Global AIDS Coordinator shall publish on a publically available Internet website the common evaluation standards of practice referred to in paragraph (3)(R). In this subsection, the term “partner country” means a country with a minimum United States Government investment of HIV/AIDS assistance of at least $5,000,000 in the prior fiscal year. Of the funds made available to carry out this section in any fiscal year, not more than 7 percent may be used for the administrative expenses of the United States Agency for International Development in support of activities described in section 2151b(c) of this title, this section, section 2151b–3 of this title, and section 2151b–4 of this title. Such amount shall be in addition to other amounts otherwise available for such purposes. In this section: The term “AIDS” means acquired immune deficiency syndrome. The term “HIV” means the human immunodeficiency virus, the pathogen that causes AIDS. The term “HIV/AIDS” means, with respect to an individual, an individual who is infected with HIV or living with AIDS. The term “relevant executive branch agencies” means the Department of State, the United States Agency for International Development, the Department of Health and Human Services (including its agencies and offices), and any other department or agency of the United States that participates in international HIV/AIDS activities pursuant to the authorities of such department or agency or this chapter.