H.R. 5501 would authorize appropriations for fiscal years 2009 through 2013 to provide assistance to foreign countries to combat HIV/AIDS, tuberculosis, and malaria.

== Detailed Summary ==

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Tom Lantos and Henry J. Hyde United States Global Leadership Against HIV/AIDS, Tuberculosis, and Malaria Reauthorization Act of 2008 <b>- Title I: Policy Planning and Coordination</b> - (Sec. 101) Amends the United States Leadership Against HIV/AIDS, Tuberculosis, and Malaria Act of 2003 (Act) to revise provisions concerning the comprehensive, five-year, global strategy to combat global HIV/AIDS.

Directs the Coordinator of United States Government Activities to Combat HIV/AIDS Globally (Coordinator) to develop a five-year strategic plan for program monitoring, operations research, and impact evaluation research of U.S. HIV/AIDS, tuberculosis, and malaria programs, including mother-to-child HIV transmission.

(Sec. 102) Amends the State Department Basic Authorities Act of 1956 to revise and expand the Coordinator's duties, including providing for: (1) establishment of an interagency working group on HIV/AIDS; (2) coordination of overall U.S. HIV/AIDS policy and programs with host countries and other relevant bilateral and multilateral aid agencies; (3) approval of U.S. programs to combat HIV/AIDS in Vietnam, Antigua and Barbuda, the Bahamas, Barbados, Belize, Dominica, Grenada, Jamaica, Montserrat, Saint Kitts and Nevis, Saint Vincent and the Grenadines, Saint Lucia, Suriname, Trinidad and Tobago, the Dominican Republic,Malawi, Swaziland, and Lesotho; and (4) working with host countries to establish HIV/AIDS prevention programs for injection drug users and participants in the commercial sex trade.

<b>Title II: Support and Multilateral Funds, Programs, and Public-Private Partnerships - </b>(Sec. 202) Amends the Act to authorize appropriations for the U.S. contribution to the Global Fund to Fight AIDS, Tuberculosis and Malaria: (1) at specified levels for FY2009-FY2010; and (2) at sums as may be necessary for FY2011-FY2013.

Extends through FY2013 limitations on U.S. contributions to the Fund: (1) exceeding 33% of contributions from all sources; and (2) respecting assistance to countries supporting acts of international terrorism.

States that U.S. policy respecting Fund support should be based upon specified transparency and accountability benchmarks.

(Sec. 203) Authorizes appropriations through FY2013 for U.S. contributions to: (1) the Vaccine Fund; (2) the International Aids Vaccine Initiative; (3) malaria vaccine development; and (4) tuberculosis vaccine development.

(Sec. 204) Directs the United States Agency for International Development (USAID) to develop and implement a program to facilitate wide-scale availability of proven microbicides that prevent HIV transmission. Authorizes FY2009-FY2013 appropriations.

(Sec. 205) Directs the Coordinator to develop and implement a plan to combat HIV/AIDS by strengthening host country health policies and systems as part of USAID's Health Systems 2020 project.

Authorizes the Secretary of the Treasury, through the Office of Technical Assistance, to provide assistance to host country finance, health, and other relevant ministries to improve their public finance management systems combat HIV/AIDS, tuberculosis, and malaria. Authorizes FY2009-FY2013 appropriations.

<b>Title III: Bilateral Efforts - Subtitle A: General Assistance and Programs </b>- (Sec. 301) Amends the Foreign Assistance Act of 1961 to set forth HIV/AIDS assistance policy targets to be achieved by 2013.

Includes countries in South and Southeast Asia, and Central and Eastern Europe within the scope of assistance to combat HIV/AIDS.

Expresses the sense of Congress: (1) respecting assistance to strengthen public health care delivery systems; and (2) that the Coordinator and relevant executive agencies should operate consistent with the &quot;Three One&quot; goals of the Joint United Nations Programme on HIV/AIDS (UNAID).

Revises and expands the scope of HIV/AIDs prevention activities.

Amends the Act to: (1) authorize appropriations through FY2013 for assistance to combat HIV/AIDS; and (2) obligate amounts from such funds through FY2013 for procurement and distribution of HIV/AIDS pharmaceuticals.

Expresses the sense of Congress respecting the importance of food security and nutrition in HIV/AIDS prevention, treatment, and care programs.

Directs the Coordinator and USAID to integrate food security and nutrition activities into HIV/AIDS prevention, treatment, and care activities.

Authorizes FY2009-FY2013 appropriations for such integrative activities.

Provides that organizations, including faith-based organizations, receiving HIV/AIDS-related funds shall not be required to endorse or utilize activities or programs to which they have a moral or religious objection, and shall not discriminated against in the solicitation or issuance of grants, contracts, or cooperative agreements for such refusal.

(Sec. 302) Amends the Foreign Assistance Act of 1961 to set forth U.S. policy goals respecting the reduction by 2015 of tuberculosis in countries with high incidence of such disease.

Sets forth eligible tuberculosis control activities, with priority to be given to activities described in the Stop TB Strategy (as defined by this Act).

Authorizes the President, through USAID, to provide increased resources to the World Health Organization (WHO) and the Stop Tuberculosis Partnership to improve the capacity of countries with high tuberculosis rates and other affected countries to implement the Stop TB Strategy and specific strategies related to drug resistant tuberculosis.

Amends the Act to authorize through FY2013: (1) appropriations for activities to combat tuberculosis; and (2) the use of certain unobligated funds for such activities.

(Sec. 303) Amends the Foreign Assistance Act of 1961 to authorize through FY2013: (1) appropriations for assistance to combat malaria; and (2) the use of certain unobligated funds for such assistance.

Amends the Act to direct the President to establish a five-year strategy to combat global malaria.

Establishes within USAID a Coordinator of United States Government Activities to Combat Malaria Globally who shall have primary responsibility for the oversight and coordination of all resources and global U.S. government activities to combat malaria.

Authorizes the President to make a U.S. contribution to the Roll Back Malaria Partnership and WHO to improve the capacity of countries with high rates of malaria and other affected countries to implement comprehensive malaria control programs.

Directs the President to report annually to the appropriate congressional committees respecting U.S. assistance for the prevention, treatment, control, and elimination of malaria.

(Sec. 304) Amends the Act to direct the President, through the Coordinator, to support the development of partnerships between U.S. and foreign institutions, including national and local health agencies, medical facilities, health education and training institutions, and faith- and community-based organizations involved in the prevention, treatment, and care of individuals with HIV/AIDS. Authorizes FY2009-FY2013 appropriations.

<b>Subtitle B: Assistance for Women, Children, and Families</b> - (Sec. 311) Amends the Act to revise requirements of the five-year strategy to combat HIV/AIDS as it pertains to mother-to-child transmission, care and treatment of family members, and care for children orphaned by HIV/AIDS.

(Sec. 312) Extends from 5 years to 10 years the annual presidential reporting requirement respecting the prevention of mother-to-child HIV transmission.

(Sec. 313) Directs the President to: (1) formulate a comprehensive global HIV/AIDS prevention strategy that addresses the vulnerabilities of women and youth to HIV infection and seeks to reduce the factors that lead to gender disparities in the rate of HIV infection (includes among the elements of such strategy HIV/AIDS prevention education); (2) provide strategy-based guidance to U.S. government field missions in appropriate countries; and (3) transmit such strategy and guidance to the appropriate congressional committees and make such information available to the public.

<b>Title IV: Authorization of Appropriations </b>- (Sec. 401) Authorizes appropriations to carry out the Act through FY2013.

(Sec. 403) Amends the Act respecting fund allocation provisions to require that: (1) 20% of all HIV/AIDS program funds be used for HIV prevention programs; (2) the Coordinator provide balanced funding for prevention activities for sexual transmission of HIV/AIDS and ensure that behavioral change programs (abstinence, delay of sexual debut, monogamy, partner reduction) are implemented for each host country based on objective epidemiological evidence as to the source of infection and in consultation with host country governments; (3) the Coordinator establish a HIV sexual transmission prevention strategy governing fund expenditures in any host country with a generalized HIV epidemic; and (4) the President report to the appropriate congressional committees respecting balanced funding.

Extends the set-aside for assistance for orphans and vulnerable children affected by HIV/AIDS through FY2013.

(Sec. 404) Prohibits foreign taxation (other than de minimus taxes) of assistance under the Act. Reprograms any funds withheld because of such taxation for HIV/AIDS assistance to another country.

<b>Title V: Sustainability and Strengthening of Health Care Systems - </b>(Sec. 501) Amends the Act to add a title VI (Sustainability and Strengthening of Health Care Systems).

States that it shall be U.S. policy to support countries receiving U.S. assistance to combat HIV/AIDS, tuberculosis, and malaria, and other health programs in developing and implementing five-year health workforce strategies.

Authorizes USAID to provide technical and financial assistance to such countries. Sets forth activities to be supported by such assistance.

Expresses the sense of Congress respecting the provision of comprehensive health care for HIV/AIDS health care workers.

Directs the Coordinator to work with the Secretary of the Treasury to reform International Monetary Fund (IMF) macroeconomic and fiscal policies that result in limitations on national and donor investments in health.

Directs the Coordinator to: (1) work with the Partnership for Supply Chain Management Systems, host countries, and nongovernmental organizations to develop host country-owned and operated public-sector procurement and supply chain management systems; (2) work with host country partners and development partners to support drug approval and registration systems that allow expeditious access to safe and effective drugs, including antiretroviral drugs; and (3) report annually to the appropriate congressional committees respecting such activities.

Authorizes FY2009-FY2013 appropriations for title VI.
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== Status of the Legislation ==

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Latest Major Action: 4/3/2008: Referred7/16/2008: Passed/agreed to Senate committee.in Senate. Status: Received in thePassed Senate and Read twice and referred to the Committee on Foreign Relations.with an amendment by Yea-Nay Vote. 80 - 16. Record Vote Number: 182.
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== Points in Favor ==

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== Points Against ==

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