--H.R.3519--
H.R.3519
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,
SECTION 1. SHORT TITLE.
This Act may be cited as the `Global AIDS and Tuberculosis Relief Act of
2000'.
SEC. 2. TABLE OF CONTENTS.
The table of contents for this Act is as follows:
Sec. 2. Table of contents.
TITLE I--ASSISTANCE TO COUNTRIES WITH LARGE POPULATIONS HAVING HIV/AIDS
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. 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.
TITLE II--INTERNATIONAL TUBERCULOSIS CONTROL
Sec. 203. Assistance for tuberculosis prevention, treatment, control,
and elimination.
TITLE III--ADMINISTRATIVE AUTHORITIES
Sec. 301. Effective program oversight.
Sec. 302. Termination expenses.
TITLE I--ASSISTANCE TO COUNTRIES WITH LARGE POPULATIONS HAVING
HIV/AIDS
SEC. 101. SHORT TITLE.
This title may be cited as the `Global AIDS Research and Relief Act of
2000'.
SEC. 102. DEFINITIONS.
(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 AIDS.
SEC. 103. FINDINGS AND PURPOSES.
(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 regions.
(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
SEC. 111. ADDITIONAL ASSISTANCE AUTHORITIES TO COMBAT HIV AND AIDS.
(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 paragraphs:
`(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
shall--
`(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 strategies.
`(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
providing--
`(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 (5).
`(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.'.
SEC. 112. VOLUNTARY CONTRIBUTION TO GLOBAL ALLIANCE FOR VACCINES AND
IMMUNIZATIONS AND INTERNATIONAL AIDS VACCINE INITIATIVE.
(a) AUTHORIZATION OF APPROPRIATIONS- Section 302 of the Foreign Assistance
Act of 1961 (22 U.S.C. 2222) is amended by adding at the end the following new
subsections:
`(k) In addition to amounts otherwise available under this section, there
is authorized to be appropriated to the President $50,000,000 for each of the
fiscal years 2001 and 2002 to be available only for United States
contributions to the Global Alliance for Vaccines and Immunizations.
`(l) In addition to amounts otherwise available under this section, there
is authorized to be appropriated to the President $10,000,000 for each of the
fiscal years 2001 and 2002 to be available only for United States
contributions to the International AIDS Vaccine Initiative.'.
(b) REPORT- At the close of fiscal year 2001, the President shall submit a
report to the appropriate congressional committees on the effectiveness of the
Global Alliance for Vaccines and Immunizations and the International AIDS
Vaccine Initiative during that fiscal year in meeting the goals of--
(1) improving access to sustainable immunization services;
(2) expanding the use of all existing, safe, and cost-effective vaccines
where they address a public health problem;
(3) accelerating the development and introduction of new vaccines and
technologies;
(4) accelerating research and development efforts for vaccines needed
primarily in developing countries; and
(5) making immunization coverage a centerpiece in international
development efforts.
(c) APPROPRIATE CONGRESSIONAL COMMITTEES DEFINED- In subsection (b), the
term `appropriate congressional committees' means the Committee on Foreign
Relations and the Committee on Appropriations of the Senate and the Committee
on International Relations and the Committee on Appropriations of the House of
Representatives.
SEC. 113. COORDINATED DONOR STRATEGY FOR SUPPORT AND EDUCATION OF ORPHANS IN
SUB-SAHARAN AFRICA.
(a) STATEMENT OF POLICY- It is in the national interest of the United
States to assist in mitigating the burden that will be placed on sub-Saharan
African social, economic, and political institutions as these institutions
struggle with the consequences of a dramatically increasing AIDS orphan
population, many of whom are themselves infected by HIV and living with AIDS.
Effectively addressing that burden and its consequences in sub-Saharan Africa
will require a coordinated multidonor strategy.
(b) DEVELOPMENT OF STRATEGY- The President shall coordinate the
development of a multidonor strategy to provide for the support and education
of AIDS orphans and the families, communities, and institutions most affected
by the HIV/AIDS epidemic in sub-Saharan Africa.
(c) DEFINITION- In this section, the term `HIV/AIDS' means, with respect
to an individual, an individual who is infected with the human
immunodeficiency virus (HIV), the pathogen that causes the acquired immune
deficiency virus (AIDS), or living with AIDS.
SEC. 114. AFRICAN CRISIS RESPONSE INITIATIVE AND HIV/AIDS TRAINING.
(a) FINDINGS- Congress finds that--
(1) the spread of HIV/AIDS constitutes a threat to security in
Africa;
(2) civil unrest and war may contribute to the spread of the disease to
different parts of the continent;
(3) the percentage of soldiers in African militaries who are infected
with HIV/AIDS is unknown, but estimates range in some countries as high as
40 percent; and
(4) it is in the interests of the United States to assist the countries
of Africa in combating the spread of HIV/AIDS.
(b) EDUCATION ON THE PREVENTION OF THE SPREAD OF AIDS- In undertaking
education and training programs for military establishments in African
countries, the United States shall ensure that classroom training under the
African Crisis Response Initiative includes military-based education on the
prevention of the spread of AIDS.
Subtitle B--World Bank AIDS Trust Fund
CHAPTER 1--ESTABLISHMENT OF THE FUND
SEC. 121. ESTABLISHMENT.
(a) NEGOTIATIONS FOR ESTABLISHMENT OF TRUST FUND- The Secretary of the
Treasury shall seek to enter into negotiations with the World Bank or the
Association, in consultation with the Administrator of the United States
Agency for International Development and other United States Government
agencies, and with the member nations of the World Bank or the Association and
with other interested parties, for the establishment within the World Bank
of--
(1) the World Bank AIDS Trust Fund (in this subtitle referred to as the
`Trust Fund') in accordance with the provisions of this chapter; and
(2) the Advisory Board to the Trust Fund in accordance with section
124.
(b) PURPOSE- The purpose of the Trust Fund should be to use contributed
funds to--
(1) assist in the prevention and eradication of HIV/AIDS and the care
and treatment of individuals infected with HIV/AIDS; and
(2) provide support for the establishment of programs that provide
health care and primary and secondary education for children orphaned by the
HIV/AIDS epidemic.
(1) IN GENERAL- The Trust Fund should be governed by a Board of
Trustees, which should be composed of representatives of the participating
donor countries to the Trust Fund. Individuals appointed to the Board should
have demonstrated knowledge and experience in the fields of public health,
epidemiology, health care (including delivery systems), and
development.
(2) UNITED STATES REPRESENTATION-
(A) IN GENERAL- Upon the effective date of this paragraph, there shall
be a United States member of the Board of Trustees, who shall be appointed
by the President, by and with the advice and consent of the Senate, and
who shall have the qualifications described in paragraph (1).
(B) EFFECTIVE AND TERMINATION DATES-
(i) EFFECTIVE DATE- This paragraph shall take effect upon the date
the Secretary of the Treasury certifies to Congress that an agreement
establishing the Trust Fund and providing for a United States member of
the Board of Trustees is in effect.
(ii) TERMINATION DATE- The position established by subparagraph (A)
is abolished upon the date of termination of the Trust Fund.
SEC. 122. GRANT AUTHORITIES.
(1) IN GENERAL- In carrying out the purpose of section 121(b), the Trust
Fund, acting through the Board of Trustees, should 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 access to affordable drugs.
(2) ACTIVITIES SUPPORTED- Among the activities the Trust Fund should
provide grants for should be--
(A) programs to promote the best practices in prevention, including
health education messages that emphasize risk avoidance such as
abstinence;
(B) measures to ensure a safe blood supply;
(C) voluntary HIV/AIDS testing and counseling;
(D) measures to stop mother-to-child transmission of HIV/AIDS,
including through diagnosis of pregnant women, access to cost-effective
treatment and counseling, and access to infant formula or other
alternatives for infant feeding;
(E) programs to provide for the support and education of AIDS orphans
and the families, communities, and institutions most affected by the
HIV/AIDS epidemic;
(F) measures for the deterrence of gender-based violence and the
provision of post-exposure prophylaxis to victims of rape and sexual
assault; and
(G) incentives to promote affordable access to treatments against AIDS
and related infections.
(3) IMPLEMENTATION OF PROGRAM OBJECTIVES- In carrying out the objectives
of paragraph (1), the Trust Fund should 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.
(b) PRIORITY- In providing grants under this section, the Trust Fund
should give priority to countries that have the highest HIV/AIDS prevalence
rate or are at risk of having a high HIV/AIDS prevalence rate.
(c) ELIGIBLE GRANT RECIPIENTS- Governments and nongovernmental
organizations should be eligible to receive grants under this section.
(d) PROHIBITION- The Trust Fund should not make grants for the purpose of
project development associated with bilateral or multilateral bank loans.
SEC. 123. ADMINISTRATION.
(a) APPOINTMENT OF AN ADMINISTRATOR- The Board of Trustees, in
consultation with the appropriate officials of the Bank, should appoint an
Administrator who should be responsible for managing the day-to-day operations
of the Trust Fund.
(b) AUTHORITY TO SOLICIT AND ACCEPT CONTRIBUTIONS- The Trust Fund should
be authorized to solicit and accept contributions from governments, the
private sector, and nongovernmental entities of all kinds.
(c) ACCOUNTABILITY OF FUNDS AND CRITERIA FOR PROGRAMS- As part of the
negotiations described in section 121(a), the Secretary of the Treasury shall,
consistent with subsection (d)--
(1) take such actions as are necessary to ensure that the Bank or the
Association will have in effect adequate procedures and standards to account
for and monitor the use of funds contributed to the Trust Fund, including
the cost of administering the Trust Fund; and
(2) seek agreement on the criteria that should be used to determine the
programs and activities that should be assisted by the Trust Fund.
(d) SELECTION OF PROJECTS AND RECIPIENTS- The Board of Trustees should
establish--
(1) criteria for the selection of projects to receive support from the
Trust Fund;
(2) standards and criteria regarding qualifications of recipients of
such support;
(3) such rules and procedures as may be necessary for cost-effective
management of the Trust Fund; and
(4) such rules and procedures as may be necessary to ensure transparency
and accountability in the grant-making process.
(e) TRANSPARENCY OF OPERATIONS- The Board of Trustees should ensure full
and prompt public disclosure of the proposed objectives, financial
organization, and operations of the Trust Fund.
SEC. 124. ADVISORY BOARD.
(a) IN GENERAL- There should be an Advisory Board to the Trust Fund.
(b) APPOINTMENTS- The members of the Advisory Board should be drawn
from--
(1) a broad range of individuals with experience and leadership in the
fields of development, health care (especially HIV/AIDS), epidemiology,
medicine, biomedical research, and social sciences; and
(2) representatives of relevant United Nations agencies and
nongovernmental organizations with on-the-ground experience in affected
countries.
(c) RESPONSIBILITIES- The Advisory Board should provide advice and
guidance to the Board of Trustees on the development and implementation of
programs and projects to be assisted by the Trust Fund and on leveraging
donations to the Trust Fund.
(d) PROHIBITION ON PAYMENT OF COMPENSATION-
(1) IN GENERAL- Except for travel expenses (including per diem in lieu
of subsistence), no member of the Advisory Board should receive compensation
for services performed as a member of the Board.
(2) UNITED STATES REPRESENTATIVE- Notwithstanding any other provision of
law (including an international agreement), a representative of the United
States on the Advisory Board may not accept compensation for services
performed as a member of the Board, except that such representative may
accept travel expenses, including per diem in lieu of subsistence, while
away from the representative's home or regular place of business in the
performance of services for the Board.
CHAPTER 2--REPORTS
SEC. 131. REPORTS TO CONGRESS.
(a) ANNUAL REPORTS BY TREASURY SECRETARY-
(1) IN GENERAL- Not later than 1 year after the date of the enactment of
this Act, and annually thereafter for the duration of the Trust Fund, the
Secretary of the Treasury shall submit to the appropriate committees of
Congress a report on the Trust Fund.
(2) REPORT ELEMENTS- The report shall include a description of--
(A) the goals of the Trust Fund;
(B) the programs, projects, and activities, including any vaccination
approaches, supported by the Trust Fund;
(C) private and governmental contributions to the Trust Fund;
and
(D) the criteria that have been established, acceptable to the
Secretary of the Treasury and the Administrator of the United States
Agency for International Development, that would be used to determine the
programs and activities that should be assisted by the Trust
Fund.
(b) GAO REPORT ON TRUST FUND EFFECTIVENESS- Not later than 2 years after
the date of the enactment of this Act, the Comptroller General of the United
States shall submit to the appropriate committees of the Congress a report
evaluating the effectiveness of the Trust Fund, including--
(1) the effectiveness of the programs, projects, and activities
described in subsection (a)(2)(B) in reducing the worldwide spread of AIDS;
and
(2) an assessment of the merits of continued United States financial
contributions to the Trust Fund.
(c) APPROPRIATE COMMITTEES DEFINED- In subsection (a), the term
`appropriate committees' means the Committee on Foreign Relations and the
Committee on Appropriations of the Senate and the Committee on International
Relations, the Committee on Banking and Financial Services, and the Committee
on Appropriations of the House of Representatives.
CHAPTER 3--UNITED STATES FINANCIAL PARTICIPATION
SEC. 141. AUTHORIZATION OF APPROPRIATIONS.
(a) IN GENERAL- In addition to any other funds authorized to be
appropriated for multilateral or bilateral programs related to HIV/AIDS or
economic development, there is authorized to be appropriated to the Secretary
of the Treasury $150,000,000 for each of the fiscal years 2001 and 2002 for
payment to the Trust Fund.
(b) ALLOCATION OF FUNDS- Of the amounts authorized to be appropriated by
subsection (a) for the fiscal years 2001 and 2002, $50,000,000 are authorized
to be available each such fiscal year only for programs that benefit
orphans.
SEC. 142. CERTIFICATION REQUIREMENT.
(a) IN GENERAL- Prior to the initial obligation or expenditure of funds
appropriated pursuant to section 141, the Secretary of the Treasury shall
certify that adequate procedures and standards have been established to ensure
accountability for and monitoring of the use of funds contributed to the Trust
Fund, including the cost of administering the Trust Fund.
(b) TRANSMITTAL OF CERTIFICATION- The certification required by subsection
(a), and the bases for that certification, shall be submitted by the Secretary
of the Treasury to Congress.
TITLE II--INTERNATIONAL TUBERCULOSIS CONTROL
SEC. 201. SHORT TITLE.
This title may be cited as the `International Tuberculosis Control Act of
2000'.
SEC. 202. FINDINGS.
Congress makes the following findings:
(1) Since the development of antibiotics in the 1950s, tuberculosis has
been largely controlled in the United States and the Western World.
(2) Due to societal factors, including growing urban decay, inadequate
health care systems, persistent poverty, overcrowding, and malnutrition, as
well as medical factors, including the HIV/AIDS epidemic and the emergence
of multi-drug resistant strains of tuberculosis, tuberculosis has again
become a leading and growing cause of adult deaths in the developing
world.
(3) According to the World Health Organization--
(A) in 1998, about 1,860,000 people worldwide died of
tuberculosis-related illnesses;
(B) one-third of the world's total population is infected with
tuberculosis; and
(C) tuberculosis is the world's leading killer of women between 15 and
44 years old and is a leading cause of children becoming orphans.
(4) Because of the ease of transmission of tuberculosis, its
international persistence and growth pose a direct public health threat to
those nations that had previously largely controlled the disease. This is
complicated in the United States by the growth of the homeless population,
the rate of incarceration, international travel, immigration, and
HIV/AIDS.
(5) With nearly 40 percent of the tuberculosis cases in the United
States attributable to foreign-born persons, tuberculosis will never be
controlled in the United States until it is controlled abroad.
(6) The means exist to control tuberculosis through screening,
diagnosis, treatment, patient compliance, monitoring, and ongoing review of
outcomes.
(7) Efforts to control tuberculosis are complicated by several barriers,
including--
(A) the labor intensive and lengthy process involved in screening,
detecting, and treating the disease;
(B) a lack of funding, trained personnel, and medicine in virtually
every nation with a high rate of the disease;
(C) the unique circumstances in each country, which requires the
development and implementation of country-specific programs; and
(D) the risk of having a bad tuberculosis program, which is worse than
having no tuberculosis program because it would significantly increase the
risk of the development of more widespread drug-resistant strains of the
disease.
(8) Eliminating the barriers to the international control of
tuberculosis through a well-structured, comprehensive, and coordinated
worldwide effort would be a significant step in dealing with the increasing
public health problem posed by the disease.
SEC. 203. ASSISTANCE FOR TUBERCULOSIS PREVENTION, TREATMENT, CONTROL, AND
ELIMINATION.
Section 104(c) of the Foreign Assistance Act of 1961 (22 U.S.C. 2151b(c)),
as amended by section 111(a) of this Act, is further amended by adding at the
end the following:
`(7)(A) Congress recognizes the growing international problem of
tuberculosis and the impact its continued existence has on those nations that
had previously largely controlled the disease. Congress further recognizes
that the means exist to control and treat tuberculosis, and that it is
therefore a major objective of the foreign assistance program to control the
disease. To this end, Congress expects the agency primarily responsible for
administering this part--
`(i) to coordinate with the World Health Organization, the Centers for
Disease Control, the National Institutes of Health, and other organizations
toward the development and implementation of a comprehensive tuberculosis
control program; and
`(ii) to set as a goal the detection of at least 70 percent of the cases
of infectious tuberculosis, and the cure of at least 85 percent of the cases
detected, in those countries in which the agency has established development
programs, by December 31, 2010.
`(B) There is authorized to be appropriated to the President, $60,000,000
for each of the fiscal years 2001 and 2002 to be used to carry out this
paragraph. Funds appropriated under this subparagraph are authorized to remain
available until expended.'.
TITLE III--ADMINISTRATIVE AUTHORITIES
SEC. 301. EFFECTIVE PROGRAM OVERSIGHT.
Section 635 of the Foreign Assistance Act of 1961 (22 U.S.C. 2395) is
amended by adding at the end thereof the following new subsection:
`(l) The Administrator of the agency primarily responsible for
administering part I may use funds made available under that part to provide
program and management oversight for activities that are funded under that
part and that are conducted in countries in which the agency does not have a
field mission or office.'.
SEC. 302. TERMINATION EXPENSES.
Section 617 of the Foreign Assistance Act of 1961 (22 U.S.C. 2367) is
amended to read as follows:
`SEC. 617. TERMINATION EXPENSES.
`(a) IN GENERAL- Funds made available under this Act and the Arms Export
Control Act, may remain available for obligation for a period not to exceed 8
months from the date of any termination of assistance under such Acts for the
necessary expenses of winding up programs related to such termination and may
remain available until expended. Funds obligated under the authority of such
Acts prior to the effective date of the termination of assistance may remain
available for expenditure for the necessary expenses of winding up programs
related to such termination notwithstanding any provision of law restricting
the expenditure of funds. In order to ensure the effectiveness of such
assistance, such expenses for orderly termination of programs may include the
obligation and expenditure of funds to complete the training or studies
outside their countries of origin of students whose course of study or
training program began before assistance was terminated.
`(b) LIABILITY TO CONTRACTORS- For the purpose of making an equitable
settlement of termination claims under extraordinary contractual relief
standards, the President is authorized to adopt as a contract or other
obligation of the United States Government, and assume (in whole or in part)
any liabilities arising thereunder, any contract with a United States or
third-country contractor that had been funded with assistance under such Acts
prior to the termination of assistance.
`(c) TERMINATION EXPENSES- Amounts certified as having been obligated for
assistance subsequently terminated by the President, or pursuant to any
provision of law, shall continue to remain available and may be reobligated to
meet any necessary expenses arising from the termination of such
assistance.
`(d) GUARANTY PROGRAMS- Provisions of this or any other Act requiring the
termination of assistance under this or any other Act shall not be construed
to require the termination of guarantee commitments that were entered into
prior to the effective date of the termination of assistance.
`(e) RELATION TO OTHER PROVISIONS- Unless specifically made inapplicable
by another provision of law, the provisions of this section shall be
applicable to the termination of assistance pursuant to any provision of
law.'.
Speaker of the House of Representatives.
Vice President of the United States and
President of the Senate.
END