[House Report 108-80]
[From the U.S. Government Publishing Office]
108th Congress Report
1st Session HOUSE OF REPRESENTATIVES 108-80
======================================================================
PROVIDING FOR CONSIDERATION OF H.R. 1298, THE UNITED STATES LEADERSHIP
AGAINST HIV/AIDS, TUBERCULOSIS, AND MALARIA ACT OF 2003
_______
April 30, 2003.--Referred to the House Calendar and ordered to be
printed
_______
Mr. Lincoln Diaz-Balart of Florida, from the Committee on Rules,
submitted the following
R E P O R T
[To accompany H. Res. 210]
The Committee on Rules, having had under consideration
House Resolution 210, by a nonrecord vote, report the same to
the House with the recommendation that the resolution be
adopted.
SUMMARY OF PROVISIONS OF THE RESOLUTION
The resolution provides for consideration of H.R. 1289, the
United States International Leadership Against HIV/AIDS,
Tuberculosis, and Malaria Act of 2003, under a structured rule.
The rule provides one hour of general debate equally divided
and controlled by the chairman and ranking minority member of
the Committee on International Relations.
The rule provides that the amendment in the nature of a
substitute recommended by the Committee on International
Relations now printed in the bill shall be considered as an
original bill for the purpose of amendment and shall be
considered as read.
The rule makes in order only those amendments printed in
this report. The rule provides that the amendments printed in
this report shall be considered only in the order printed in
this report, may be offered only by a Member designated in this
report, shall be considered as read, shall be debatable for the
time specified in this report equally divided and controlled by
the proponent and an opponent, shall not be subject to
amendment, and shall not be subject to a demand for a division
of the question in the House or in the Committee of the Whole.
The rule waives all points of order against the amendments
printed in this report.
The rule provides one motion to recommit with or without
instructions.
SUMMARY OF AMENDMENTS MADE IN ORDER UNDER THE RULE
(Summaries derived from information provided by sponsors.)
1. Tauzin/Brown (OH)--Establishes priorities for the
distribution of resources based on factors such as the size and
demographics of specific nations to ensure that the countries
that need assistance the most receive it first. Commissions a
report by the Institutes of Medicine that compares the success
rates of various programs and methods used under the strategy
set forth in H.R. 1298. Adds accountability measures to the
funds authorized for the Global Fund. States that if at any
point administrative expenses within the Global Fund exceed 10
percent of total expenditures of the Fund for any 2-year
period, the U.S. shall withhold an equal amount from its
contribution the following year. Requires the HIV/AIDS
Coordinator to make available to Congress information on the
Global Fund, including all financial and accounting statements
and reports provided to the Global Fund by organizations
contracted to audit recipients of funds and project proposals
submitted by applicants and grantees. Encourages the Centers
for Disease Control, in coordination with the Global AIDS
Coordinator, to develop and implement effective strategies to
improve injection safety and improve the education and
information provided to the public and to health professionals.
Directs the Department of Health and Human Services to conduct
a study on illegal importation into the U.S. of prescription
drugs donated or sold for humanitarian efforts. (20 minutes)
2. Crowley--Requires that the teaching of programs to
combat HIV/AIDS should involve a curriculum targeted to men and
boys emphasizing gender equality and respect for women and
girls. (10 minutes)
3. Biggert--Expresses the sense of Congress that the
President should conduct an outreach campaign to inform the
public of the existence of the Global Fund and encourage
private contributions to the Global Fund by establishing and
operating an Internet website and making public service
announcements. (10 minutes)
4. Stearns--Requires that for every dollar paid to any
individual Global Fund staffer that is over the amount of the
U.S. Vice President's salary, that there be a deduction of the
same amount from the next year's appropriation to the Global
Fund. All funds would continue to go to HIV/AIDS programs. The
President may waive the provision for national security
interests. (10 minutes)
5. Ballance--Expresses the sense of Congress that African
nations that object to U.S. food aid on non-scientific grounds
should accept this food assistance to improve
nutrition,particuarly for HIV/AIDS patients in those countries.
Findings include discussion of food insecurity among HIV/AIDS infected
individuals, the link between malnutrition and the accelerated
deterioration of HIV/AIDS patients, as well as the diminished impact of
HIV/AIDS drug therapy in malnourished individuals. Makes a technical
change, removing an inaccurate reference to nevirapine. (10 minutes)
6. Smith, Nick (MI)--Reconciles funding levels with the
President's budget and the budget resolution. Authorizes $2
billion in fiscal year 2004, as called for by the President's
budget and the budget resolution. Increases the authorization
by $500 million in each subsequent year until it reaches $4
billion in fiscal year 2008. Total authorization of $15 billion
over 5 years is maintained. (10 minutes)
7. Millender-McDonald--Calls for a pilot program of
assistance for children and families affected by HIV/AIDS that
ensures the inheritance rights of women, particularly women in
African countries. Requires that the Presidential report on the
pilot program include a description of activities undertaken to
carry out the pilot program. Calls for an authorization of
appropriations to fund the pilot program. (10 minutes)
8. McCollum--Ensures that orphans and vulnerable children
affected by HIV/AIDS receive not less than 10 percent of the
amounts appropriated for HIV/AIDS assistance for fiscal years
2006 through 2008, of which not less than 50 percent of the
funding shall be channeled through non-profit, non-governmental
organizations, including faith-based organizations, that
implement programs at the community level. (10 minutes)
9. Jackson-Lee--Expresses the sense of Congress that U.S.
agencies should encourage U.S. businesses and private groups to
provide assistance to sub-Saharan African countries to reduce
the incidence of HIV/AIDS. Funds and assistance should be
coordinated through a privately funded HIV/AIDS Response Fund.
(10 minutes)
10. Smith, Chris (NJ)/Hyde/Stupak/Renzi--Clarification of
the existing conscience protection language. Ensures that a
qualified grantee is not disqualified from receiving HIV/AIDS
funds because the grantee has a religious or moral objection to
participating in some types of HIV/AIDS prevention or
treatment. (20 minutes)
11. Pitts/Hyde--Specifies that of the amount set aside for
HIV/AIDS prevention in bilateral assistance, 33% should go to
abstinence-until-marriage programs. (20 minutes)
TEXT OF AMENDMENTS MADE IN ORDER
1. An Amendment To Be Offered by Representative Tauzin of Louisiana, or
His Designee, Debatable for 20 Minutes
Page 2, in the table of contents at section 1(b), after the
item relating to section 305, insert the following:
Sec. 306. Strategies to improve injection safety.
Sec. 307. Study on illegal diversions of prescription drugs.
Page 20, line 19, insert ``and reduce duplication'' after
``improve coordination''.
Page 20, line 25, strike ``resources; and'' and insert
``resources;''.
Page 21, line 3, strike ``research.'' and insert
``research;''.
Page 21, after line 3, insert the following:
(9) establish priorities for the distribution of
resources based on factors such as the size and
demographics of the population with HIV/AIDS,
tuberculosis, and malaria and the needs of that
population and the existing infrastructure or funding
levels that may exist to cure, treat, and prevent HIV/
AIDS, tuberculosis, and malaria; and
(10) include initiatives describing how the President
will maximize the leverage of private sector dollars in
reduction and treatment of HIV/AIDS, tuberculosis, and
malaria.
Page 26, after line 13, insert the following:
(c) Study; Distribution of Resources.--
(1) Study.--Not later than 3 years after the date of
the enactment of this Act, the Institute of Medicine
shall publish findings comparing the success rates of
the various programs and methods used under the
strategy described in subsection (a) to reduce,
prevent, and treat HIV/AIDS, tuberculosis, and malaria.
(2) Distribution of resources.--In prioritizing the
distribution of resources under the strategy described
in subsection (a), the President shall consider the
findings published by the Institute of Medicine under
this subsection.
Page 34, line 21, strike ``in the fiscal year 2004'' and
insert ``for the period of fiscal year 2004 beginning on
January 1, 2004''.
Page 36, after line 13, insert the following:
(iii) If at any time the President determines
that the expenses of the Governing,
Administrative, and Advisory Bodies (including
the Partnership Forum, the Foundation Board,
the Secretariat, and the Technical Review
Board) of the Global Fund exceed 10 percent of
the total expenditures of the Fund for any 2-
year period, the United States shall withhold
from its contribution for the next fiscal year
an amount equal the to the average annual
amount expended by the Fund for such 2-year
period for the expenses of the Governing,
Administrative, and Advisory Bodies in excess
of 10 percent of the total expenditures of the
Fund.
(iv) The President may waive the application
of clause (iii) if the President determines
that extraordinary circumstances warrant such a
waiver. No waiver under this clause may be for
any period that exceeds 1 year.
Page 36, line 14, strike ``(B) Any amount made available
under this subsection that is withheld by reason of
subparagraph (A)'' and insert ``(B)(i) Any amount made
available under this subsection that is withheld by reason of
subparagraph (A)(i)''.
Page 36, after line 19, insert the following:
(ii) Any amount made available under this
subsection that is withheld by reason of
subparagraph (A)(iii) shall be transferred to
the Activities to Combat HIV/AIDS Globally Fund
and shall remain available under the same terms
and conditions as funds appropriated pursuant
to the authorization of appropriations under
section 401 for HIV/AIDS assistance.
Page 39, after line 9, insert the following:
(f) Provision of Information to Congress.--The Coordinator of
United States Government Activities to Combat HIV/AIDS Globally
shall make available to the Congress the following documents
within 30 days of a request by the Congress for such documents:
(1) All financial and accounting statements for the
Global Fund and the Activities to Combat HIV/AIDS
Globally Fund, including administrative and grantee
statements.
(2) Reports provided to the Global Fund and the
Activities to Combat HIV/AIDS Globally Fund by
organizations contracted to audit recipients of funds.
(3) Project proposals submitted by applicants for
funding from the Global Fund and the Activities to
Combat HIV/AIDS Globally Fund, but which were not
funded.
(4) Progress reports submitted to the Global Fund and
the Activities to Combat HIV/AIDS Globally Fund by
grantees.
Page 69, after line 3, insert the following:
SEC. 306. STRATEGIES TO IMPROVE INJECTION SAFETY.
Section 307 of the Public Health Service Act (42 U.S.C. 242l)
is amended by adding at the end the following:
``(d) In carrying out immunization programs and other
programs in developing countries for the prevention, treatment,
and control of infectious diseases, including HIV/AIDS,
tuberculosis, and malaria, the Director of the Centers for
Disease Control and Prevention, in coordination with the
Coordinator of United States Government Activities to Combat
HIV/AIDS Globally, the National Institutes of Health, national
and local government, and other organizations, such as the
World Health Organization and the United Nations Children's
Fund, shall develop and implement effective strategies to
improve injection safety, including eliminating unnecessary
injections, promoting sterile injection practices and
technologies, strengthening the procedures for proper needle
and syringe disposal, and improving the education and
information provided to the public and to health
professionals.''.
SEC. 307. STUDY ON ILLEGAL DIVERSIONS OF PRESCRIPTION DRUGS.
Not later than 180 days after enactment of this Act, the
Secretary of Health and Human Services, in coordination with
other agencies, shall submit a report to the Congress that
includes the following:
(1) A thorough accounting of evidence indicating
illegal diversion into the United States of
prescription drugs donated or sold for humanitarian
efforts, and an estimate of the extent of such
diversion.
(2) Recommendations to increase the administrative
and enforcement powers of the United States to
identify, monitor, and prevent the illegal diversion
into the United States of prescription drugs donated or
sold for humanitarian efforts.
(3) Recommendations and guidelines to advise and
provide technical assistance to developing countries on
how to implement a program that minimizes diversion
into the United States of prescription drugs donated or
sold for humanitarian efforts.
----------
2. An Amendment To Be Offered by Representative Crowley of New York, or
His Designee, Debatable for 10 Minutes
Page 22, after line 22, insert the following (and redesignate
subsequent paragraphs accordingly):
(F) a description of the specific strategies
developed to encourage men to be responsible in
their sexual behavior, child rearing and to
respect women including the reduction of sexual
violence and coercion;
(G) a description of the specific strategies
developed to increase women's access to
employment opportunities, income, productive
resources, and microfinance programs;
Page 43, line 10, after ``sexual partnering,'' insert
``reducing sexual violence and coercion, including child
marriage, widow inheritance, and polygamy,''.
Page 43, after line 21, insert the following (and redesignate
subsequent paragraphs accordingly):
(C) assistance for the purpose of encouraging
men to be responsible in their sexual behavior,
child rearing, and to respect women;
Page 44, line 7, strike ``and'' at the end.
Page 44, line 10, strike the period at the end and insert
``and''.
Page 44, after line 10, insert the following:
(G) assistance for the purpose of increasing
women's access to employment opportunities,
income, productive resources, and microfinance
programs, where appropriate.
----------
3. An Amendment To Be Offered by Representative Biggert of Illinois, or
Her Designee, Debatable for 10 Minutes
Page 33, after line 20, insert the following:
(a) Findings.--The Congress finds as follows:
(1) The establishment of the Global Fund in January
2002 is consistent with the general principles for an
international AIDS trust fund first outlined by the
Congress in the Global AIDS and Tuberculosis Relief Act
of 2000 (Public Law 106-264).
(2) Section 2, Article 5 of the bylaws of the Global
Fund provides for the International Bank for
Reconstruction and Development to serve as the initial
collection trustee for the Global Fund.
(3) The trustee agreement signed between the Global
Fund and the International Bank for Reconstruction and
Development narrows the range of duties to include
receiving and investing funds from donors, disbursing
the funds upon the instruction of the Global Fund,
reporting on trust fund resources to donors and the
Global Fund, and providing an annual external audit
report to the Global Fund.
Page 33, line 20, strike ``(a)'' and insert ``(b)''.
Page 34, line 5, strike ``(b)'' and insert ``(c)''.
Page 34, line 14, strike ``(c)'' and insert ``(d)''.
Page 37, line 18, strike ``(d)'' and insert ``(e)''.
Page 38, line 25, strike ``(e)'' and insert ``(f)''.
Page 39, after line 9, insert the following:
(g) Sense of the Congress Regarding Encouragement of Private
Contributions to the Global Fund.--It is the sense of the
Congress that the President should--
(1) conduct an outreach campaign that is designed
to--
(A) inform the public of the existence of--
(i) the Global Fund; and
(ii) any entity that will accept
private contributions intended for use
by the Global Fund; and
(B) encourage private contributions to the
Global Fund; and
(2) encourage private contributions intended for use
by the Global Fund by--
(A) establishing and operating an Internet
website, and publishing information about the
website; and
(B) making public service announcements on
radio and television.
----------
4. An Amendment To Be Offered by Representative Stearns of Florida, or
His Designee, Debatable for 10 Minutes
Page 36, after line 13, insert the following:
(iii) If, at any time during any of the
fiscal years 2004 through 2008, the President
determines that the salary of any individual
employed by the Global Fund exceeds the salary
of the Vice President of the United States (as
determined under section 104 of title 3, United
States Code) for that fiscal year, then the
United States shall withhold from its
contribution for the next fiscal year an amount
equal to the aggregate amount by which the
salary of each such individual exceeds the
salary of the Vice President of the United
States.
Page 36, line 14, strike ``(B)'' and insert ``(B)(i)''.
Page 36, beginning on each of lines 15 and 17, strike
``subparagraph (A)'' and insert ``subparagraph (A)(i)''.
Page 36, after line 19, insert the following:
(ii) Any amount made available under this
subsection that is withheld by reason of clause
(ii) or (iii) of subparagraph (A) is authorized
to be made available to carry out section 104A
of the Foreign Assistance Act of 1961 (as added
by section 301 of this Act). Amounts made
available under the preceding sentence are in
addition to amounts appropriated pursuant to
the authorization of appropriations under
section 401 of this Act for HIV/AIDS
assistance.
----------
5. An Amendment To Be Offered by Representative Ballance of North
Carolina, or His Designee, Debatable for 10 Minutes
Page 55, after line 10, insert the following:
(g) Sense of Congress Relating to Food Assistance for
Individuals Living With HIV/AIDS.--
(1) Findings.--Congress finds the following:
(A) The United States provides more than 60
percent of all food assistance worldwide.
(B) According to the United Nations World
Food Program and other United Nations agencies,
food insecurity of individuals infected or
living with HIV/AIDS is a major problem in
countries with large populations of such
individuals, particularly in African countries.
(C) Although the United States is willing to
provide food assistance to these countries in
need, a few of the countries object to part or
all of the assistance because of fears of
benign genetic modifications to the foods.
(D) Healthy and nutritious foods for
individuals infected or living with HIV/AIDS
are an important complement to HIV/AIDS
medicines for such individuals.
(E) Individuals infected with HIV have higher
nutritional requirements than individuals who
are not infected with HIV, particularly with
respect to the need for protein. Also, there is
evidence to suggest that the full benefit of
therapy to treat HIV/AIDS may not be achieved
in individuals who are malnourished,
particularly in pregnant and lactating women.
(2) Sense of congress.--It is therefore the sense of
Congress that United States food assistance should be
accepted by countries with large populations of
individuals infected or living with HIV/AIDS,
particularly African countries, in order to help feed
such individuals.
Page 69, line 19, strike ``The drug nevirapine reduces'' and
insert ``Certain antiretroviral drugs reduce''.
----------
6. An Amendment To Be Offered by Representative Nick Smith of Michigan,
or His Designee, Debatable for 10 Minutes
Page 81, beginning on line 22, strike ``$3,000,000,000 for
each of the fiscal years 2004 through 2008'' and insert
``$2,000,000,000 for fiscal year 2004, $2,500,000,000 for
fiscal year 2005, $3,000,000,000 for fiscal year 2006,
$3,500,000,000 for fiscal year 2007, and $4,000,000,000 for
fiscal year 2008''.
----------
7. An Amendment To Be Offered by Representative Millender-McDonald of
California, or Her Designee, Debatable for 10 Minutes
Page 74, after line 10, insert the following (and redesignate
subsequent paragraphs accordingly):
(4) ensure the importance of inheritance rights of
women, particularly women in African countries, due to
the exponential growth in the number of young widows,
orphaned girls, and grandmothers becoming heads of
households as a result of the HIV/AIDS pandemic;
Page 75, line 4, add at the end the following new sentence:
``Such report should include a description of activities
undertaken to carry out subsection (b)(4).''.
Page 75, line 11, add at the end the following new sentence:
``A significant percentage of the amount appropriated pursuant
to the authorization of appropriations under the preceding
sentence for a fiscal year should be made available to carry
out subsection (b)(4).''.
----------
8. An Amendment To Be Offered by Representative McCollum of Minnesota,
or Her Designee, Debatable for 10 Minutes
Page 83, line 14, strike ``For'' and insert ``(a) Therapeutic
Medical Care.--For''.
Page 83, after line 22, add the following new subsection:
(b) Orphans and Vulnerable Children.--For fiscal years 2004
through 2008, not less than 10 percent of the amounts
appropriated pursuant to the authorization of appropriations
under section 401 for HIV/AIDS assistance for each such fiscal
year shall be expended for assistance for orphans and
vulnerable children affected by HIV/AIDS, of which such amount
at least 50 percent shall be provided through non-profit,
nongovernmental organizations, including faith-based
organizations, that implement programs on the community level.
----------
9. An Amendment To Be Offered by Representative Jackson-Lee of Texas,
or Her Designee, Debatable for 10 Minutes
At the end of the bill, add the following (and conform the
table of contents accordingly):
SEC. 404. ASSISTANCE FROM THE UNITED STATES PRIVATE SECTOR TO PREVENT
AND REDUCE HIV/AIDS IN SUB-SAHARAN AFRICA.
It is the sense of Congress that United States businesses
should be encouraged to provide assistance to sub-Saharan
African countries to prevent and reduce the incidence of HIV/
AIDS in sub-Saharan Africa. In providing such assistance,
United States businesses should be encouraged to consider the
establishment of an HIV/AIDS Response Fund in order to provide
for coordination among such businesses in the collection and
distribution of the assistance to sub-Saharan African
countries.
----------
10. An Amendment To Be Offered by Representative Chris Smith of New
Jersey, or His Designee, Debatable for 20 Minutes
Page 54, line 21, insert before the period the following: ``,
or to endorse, utilize, or participate in a prevention method
or treatment program to which the organization has a religious
or moral objection''.
----------
11. An Amendment To Be Offered by Representative Pitts of Pennsylvania,
or His Designee, Debatable for 20 Minutes
Page 83, line 10, insert before the semicolon the following:
``, of which such amount at least 33 percent should be expended
for abstinence-until-marriage programs''.
Page 83, line 22, add at the end the following new sentence:
``For fiscal years 2006 through 2008, not less than 33 percent
of the amounts appropriated pursuant to the authorization of
appropriations under section 401 for HIV/AIDS prevention
consistent with section 104A(d) of the Foreign Assistance Act
of 1961 (as added by section 301 of this Act) for each such
fiscal year shall be expended for abstinence-until-marriage
programs.''.