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U.S. Code as of:
01/19/04
Section 2151b-2. Assistance to combat HIV/AIDS
(a) Finding
Congress recognizes that the alarming spread of HIV/AIDS in
countries in sub-Saharan Africa, the Caribbean, and other
developing countries is a major global health, national security,
development, and humanitarian crisis.
(b) Policy
It is a major objective of the foreign assistance program of the
United States to provide assistance for the prevention, treatment,
and control of HIV/AIDS. The United States and other developed
countries should provide assistance to countries in sub-Saharan
Africa, the Caribbean, and other countries and areas to control
this crisis through HIV/AIDS prevention, treatment, monitoring, and
related activities, particularly activities focused on women and
youth, including strategies to protect women and prevent
mother-to-child transmission of the HIV infection.
(c) Authorization
(1) In general
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,
and other countries and areas.
(2) Role of NGOs
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, and other countries and areas affected by
the HIV/AIDS pandemic.
(3) Coordination of assistance efforts
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 foreign countries, appropriate
governmental and nongovernmental organizations, and relevant
executive branch agencies.
(d) Activities supported
Assistance provided under subsection (c) of this section shall,
to the maximum extent practicable, be used to carry out the
following activities:
(1) Prevention
Prevention of HIV/AIDS through activities including -
(A) programs and efforts that are designed or intended to
impart knowledge with the exclusive purpose of helping
individuals avoid behaviors that place them at risk of HIV
infection, including integration of such programs into health
programs and the inclusion in counseling programs of
information on methods of avoiding infection of HIV, including
delaying sexual debut, abstinence, fidelity and monogamy,
reduction of casual sexual partnering, reducing sexual violence
and coercion, including child marriage, widow inheritance, and
polygamy, and where appropriate, use of condoms;
(B) assistance to establish and implement culturally
appropriate HIV/AIDS education and prevention programs that
focus on helping individuals avoid infection of HIV/AIDS,
implemented through nongovernmental organizations, including
faith-based and community-based organizations, particularly
those organizations that utilize both professionals and
volunteers with appropriate skills, experience, and community
presence;
(C) assistance for the purpose of encouraging men to be
responsible in their sexual behavior, child rearing, and to
respect women;
(D) assistance for the purpose of providing voluntary testing
and counseling (including the incorporation of confidentiality
protections with respect to such testing and counseling);
(E) assistance for the purpose of preventing mother-to-child
transmission of the HIV infection, including medications to
prevent such transmission and access to infant formula and
other alternatives for infant feeding;
(F) assistance to ensure a safe blood supply and sterile
medical equipment;
(G) assistance to help avoid substance abuse and intravenous
drug use that can lead to HIV infection; and
(H) assistance for the purpose of increasing women's access
to employment opportunities, income, productive resources, and
microfinance programs, where appropriate.
(2) Treatment
The treatment and care of individuals with HIV/AIDS, including
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(A) assistance to establish and implement programs to
strengthen and broaden indigenous health care delivery systems
and the capacity of such systems to deliver HIV/AIDS
pharmaceuticals and otherwise provide for the treatment of
individuals with HIV/AIDS, including clinical training for
indigenous organizations and health care providers;
(B) assistance to strengthen and expand hospice and
palliative care programs to assist patients debilitated by
HIV/AIDS, their families, and the primary caregivers of such
patients, including programs that utilize faith-based and
community-based organizations; and
(C) assistance for the purpose of the care and treatment of
individuals with HIV/AIDS through the provision of
pharmaceuticals, including antiretrovirals and other
pharmaceuticals and therapies for the treatment of
opportunistic infections, nutritional support, and other
treatment modalities.
(3) Preventative intervention education and technologies
(A) With particular emphasis on specific populations that
represent a particularly high risk of contracting or spreading
HIV/AIDS, including those exploited through the sex trade,
victims of rape and sexual assault, individuals already infected
with HIV/AIDS, and in cases of occupational exposure of health
care workers, assistance with efforts to reduce the risk of
HIV/AIDS infection including post-exposure pharmaceutical
prophylaxis, and necessary pharmaceuticals and commodities,
including test kits, condoms, and, when proven effective,
microbicides.
(B) Bulk purchases of available test kits, condoms, and, when
proven effective, microbicides that are intended to reduce the
risk of HIV/AIDS transmission and for appropriate program support
for the introduction and distribution of these commodities, as
well as education and training on the use of the technologies.
(4) Monitoring
The monitoring of programs, projects, and activities carried
out pursuant to paragraphs (1) through (3), including -
(A) monitoring to ensure that adequate controls are
established and implemented to provide HIV/AIDS pharmaceuticals
and other appropriate medicines to poor individuals with
HIV/AIDS;
(B) appropriate evaluation and surveillance activities;
(C) monitoring to ensure that appropriate measures are being
taken to maintain the sustainability of HIV/AIDS
pharmaceuticals (especially antiretrovirals) and ensure that
drug resistance is not compromising the benefits of such
pharmaceuticals; and
(D) monitoring to ensure appropriate law enforcement
officials are working to ensure that HIV/AIDS pharmaceuticals
are not diminished through illegal counterfeiting or black
market sales of such pharmaceuticals.
(5) Pharmaceuticals
(A) Procurement
The procurement of HIV/AIDS pharmaceuticals, antiviral
therapies, and other appropriate medicines, including medicines
to treat opportunistic infections.
(B) Mechanisms for quality control and sustainable supply
Mechanisms to ensure that such HIV/AIDS pharmaceuticals,
antiretroviral therapies, and other appropriate medicines are
quality-controlled and sustainably supplied.
(C) Distribution
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.
(6) Related activities
The conduct of related activities, including -
(A) the care and support of children who are orphaned by the
HIV/AIDS pandemic, including services designed to care for
orphaned children in a family environment which rely on
extended family members;
(B) improved infrastructure and institutional capacity to
develop and manage education, prevention, and treatment
programs, including training and the resources to collect and
maintain accurate HIV surveillance data to target programs and
measure the effectiveness of interventions; and
(C) vaccine research and development partnership programs
with specific plans of action to develop a safe, effective,
accessible, preventive HIV vaccine for use throughout the
world.
(7) Comprehensive HIV/AIDS public-private partnerships
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 -
(A) support the development, implementation, and management
of comprehensive HIV/AIDS plans in support of the national
HIV/AIDS strategy;
(B) operate at all times in a manner that emphasizes
efficiency, accountability, and results-driven programs;
(C) engage both local and foreign development partners and
donors, including businesses, government agencies, academic
institutions, nongovernmental organizations, foundations,
multilateral development agencies, and faith-based
organizations, to assist the country in coordinating and
implementing HIV/AIDS prevention, treatment, and monitoring
programs in accordance with its national HIV/AIDS strategy;
(D) provide technical assistance, consultant services,
financial planning, monitoring and evaluation, and research in
support of the national HIV/AIDS strategy; and
(E) establish local human resource capacities for the
national HIV/AIDS strategy through the transfer of medical,
managerial, leadership, and technical skills.
(e) Annual report
(1) In general
Not later than January 31 of each year, the President shall
submit to the Committee on Foreign Relations of the Senate and
the Committee on International Relations of the House of
Representatives a report on the implementation of this section
for the prior fiscal year.
(2) Report elements
Each report shall include -
(A) a description of efforts made by each relevant executive
branch agency to implement the policies set forth in this
section, section 2151b-3 of this title, and section 2151b-4 of
this title;
(B) a description of the programs established pursuant to
such sections; and
(C) a detailed assessment of the impact of programs
established pursuant to such sections, including -
(i)(I) the effectiveness of such programs in reducing the
spread of the HIV infection, particularly in women and girls,
in reducing mother-to-child transmission of the HIV
infection, and in reducing mortality rates from HIV/AIDS; and
(II) the number of patients currently receiving treatment
for AIDS in each country that receives assistance under this
chapter.
(ii) the progress made toward improving health care
delivery systems (including the training of adequate numbers
of staff) and infrastructure to ensure increased access to
care and treatment;
(iii) with respect to tuberculosis, the increase in the
number of people treated and the increase in number of
tuberculosis patients cured through each program, project, or
activity receiving United States foreign assistance for
tuberculosis control purposes; and
(iv) with respect to malaria, the increase in the number of
people treated and the increase in number of malaria patients
cured through each program, project, or activity receiving
United States foreign assistance for malaria control
purposes.
(f) Funding limitation
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.
(g) Definitions
In this section:
(1) AIDS
The term "AIDS" means acquired immune deficiency syndrome.
(2) HIV
The term "HIV" means the human immunodeficiency virus, the
pathogen that causes AIDS.
(3) HIV/AIDS
The term "HIV/AIDS" means, with respect to an individual, an
individual who is infected with HIV or living with AIDS.
(4) Relevant executive branch agencies
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.
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