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 ==

<summary>
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<b>(This measure has not been amended since it was passed by the United States Leadership Against HIV/AIDS, Tuberculosis, and Malaria ActSenate on July 16, 2008. The summary of 2003 (Act) to revise provisions concerning the comprehensive, five-year, global strategy to combat global HIV/AIDS.that version is repeated here.)</b>

Directs the Coordinator ofTom Lantos and Henry J. Hyde United States Government Activities to Combat HIV/AIDS Globally (Coordinator) to develop a five-year strategic plan for program monitoring, operations research,Global Leadership Against HIV/AIDS, Tuberculosis, and impact evaluation researchMalaria Reauthorization Act of U.S.2008 - <b>Title I: Policy Planning and Coordination - </b>(Sec. 101) Amends the United States Leadership Against HIV/AIDS, tuberculosis,Tuberculosis, and malaria programs, including mother-to-child HIV transmission.Malaria Act of 2003 (Act) to revise the provisions of the President's comprehensive five-year global strategy (and related report) to combat HIV/AIDS.

(Sec. 102) AmendsDirects the State Department Basic Authorities ActCoordinator of 1956United States Government Activities to revise and expandCombat HIV/AIDS Globally (Coordinator) to: (1) commission a study by the Coordinator's duties, including providing for: (1) establishmentInstitute 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 bilateralMedicine to assess progress and multilateral aid agencies; (3) approvaloutcomes of U.S. programs to combatglobal 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 (authorizes appropriations for injection drug userssuch study); and participants in the commercial sex trade.(2) publish a best practices report.

<b>Title II: Support and Multilateral Funds, Programs, and Public-Private Partnerships - </b>(Sec. 202) AmendsRequires a report from 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.Comptroller General.

Extends through FY2013 limitations on U.S. contributions toDirects the Fund: (1) exceeding 33%Inspectors General of contributions from all sources;the Department of State and (2) respecting assistance to countries supporting actsBroadcasting Board of international terrorism.Governors, the Department of Health and Human Services (HHS), and the United States Agency for International Development (USAID) to jointly develop five coordinated annual plans for oversight activity. Authorizes funding.

States that(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 respecting Fund support should be based upon specified transparency and accountability benchmarks.programs with host countries and other relevant bilateral and multilateral aid agencies; (3) approval of U.S. programs to combat HIV/AIDS in Vietnam; and (4) working with host countries to establish HIV/AIDS prevention programs for injection drug users and participants in the commercial sex trade.

(Sec. 203) Authorizes appropriations through FY2013Adds Vietnam to the list of countries approved for U.S. contributions to: (1) the Vaccine Fund; (2) the International Aids Vaccine Initiative; (3) malaria vaccine development; and (4) tuberculosis vaccine development.activities relating to combating HIV/AIDS.

(Sec. 204) Directs (Sec. 103) Expresses the United States Agency for International Development (USAID) to develop and implement a program to facilitate wide-scale availabilitysense of proven microbicides that prevent HIV transmission. Authorizes FY2009-FY2013 appropriations. Congress about the importance of country coordinators, foreign service nationals, and staffing levels for country teams.

(Sec. 205) Directs<b>Title II: Support and Multilateral Funds, Programs, and Public-Private Partnerships</b> - (Sec. 201) Amends the CoordinatorForeign Assistance Act of 1961 to developauthorize FY2009-FY2013 appropriations for U.S. contributions to: (1) tuberculosis vaccine development programs, which may include the Aeras Global TB Vaccine Foundation; (2) the Vaccine Fund; (3) the International AIDS Vaccine Initiative; and implement a plan to combat HIV/AIDS by strengthening host country health policies and systems as part(4) the Malaria Vaccine Initiative of USAID'sthe Program for Appropriate Technologies in Health Systems 2020 project. (PATH).

Authorizes(Sec. 202) Authorizes FY2009-FY2013 appropriations for the Secretary ofU.S. contribution to the Treasury, through the Office of Technical Assistance,Global Fund to provide assistance to host country finance, health,Fight AIDS, Tuberculosis and other relevant ministries to improve their public finance management systems combat HIV/AIDS, tuberculosis, and malaria. Authorizes FY2009-FY2013 appropriations.Malaria.

<b>Title III: Bilateral Efforts - Subtitle A: General Assistance and Programs </b>- (Sec. 301) AmendsExtends through FY2013 limitations on U.S. contributions to the Foreign Assistance ActFund: (1) exceeding 33% of 1961contributions from all sources; and (2) respecting assistance to set forth HIV/AIDScountries supporting acts of international terrorism (includes a discretionary presidential waiver for specified assistance policy targets to be achieved by 2013.Sudan if in the U.S. national interest).

Includes countries in South and Southeast Asia, and Central and Eastern Europe withinStates that the scope of assistanceUnited States shall work with the Global Fund to combat HIV/AIDS.dissuade governments from imposing duties, tariffs, or taxes on Global Fund-provided goods or services.

Expresses the senseWithholds 20% of Congress: (1) respecting assistance to strengthen public health care delivery systems; and (2) thatFY2010-FY2013 appropriations for the Coordinator and relevant executive agencies should operate consistent withGlobal Fund until the &quot;Three One&quot; goalsSecretary of the Joint United Nations Programme on HIV/AIDS (UNAID). State certifies achievement of certain accountability and transparency benchmarks.

Revises and expands(Sec. 203) States that Congress recognizes the scopeneed to expand the range of interventions for preventing the transmission of HIV/AIDsHIV, including non-vaccine prevention activities. methods that can be controlled by women.

Amends the Public Health Service Act to: (1) authorize appropriations through FY2013 for assistance to combat HIV/AIDS; and (2) obligate amounts from such funds through FY2013direct the Office of AIDS Research (of the National Institutes of Health (NIH)) to expedite implementation of federal strategic plans for procurementmicrobicide research and distribution of HIV/AIDS pharmaceuticals. update such plans.

ExpressesDirects the sense of Congress respecting the importanceNational Institute of food securityAllergy and nutrition in HIV/AIDS prevention, treatment,Infectious Diseases (of NIH) to conduct microbicide research on, and care programs. development of, methods for women to prevent HIV transmission, which may include microbicides.

DirectsEncourages the CoordinatorCenters for Disease Control and USAIDPrevention (CDCP) to integrate food security and nutrition activities into HIV/AIDS prevention, treatment,implement the Centers' microbicide agenda to support microbicide research and care activities. development for prevention of HIV transmission. Authorizes FY2009-2013 appropriations.

Authorizes FY2009-FY2013 appropriations forStates that USAID, in cooperation with the Coordinator, may facilitate wide scale availability of microbicides that prevent the transmission of HIV if such integrative activities.microbicides are Food and Drug Administration (FDA)-approved. Authorizes FY2009-FY2013 appropriations.

Provides that organizations, including faith-based organizations, receiving HIV/AIDS-related funds shall not be required(Sec. 204) Amends the Act to endorse or utilize activities orauthorize the Secretary of the Treasury, through the Office of Technical Assistance, to provide technical assistance to host countries to improve their public finance management systems in order to receive assistance and operate their own programs to which they have a moral or religious objection,combat HIV/AIDS, malaria, and shall not discriminated against in the solicitation or issuance of grants, contracts, or cooperative agreements for such refusal.tuberculosis. Authorizes FY2009-FY2013 appropriations.

(Sec. 205) Amends the Public Health Service Act to authorize the Secretary of Health and Human Services to participate with other countries in cooperative research, health care services, and other related activities.

Eliminates the provision prohibiting the Secretary from providing financial assistance for facility construction in a foreign country.

(Sec. 206) Authorizes USAID to strengthen the capacity of developing countries to: (1) conduct proper protocols for the introduction of new and safe vaccines; (2) review protocols for, and improve implementation of, clinical trials and impact studies; and (3) ensure adequate supply chain and delivery systems.

Directs the Secretary of the Treasury to: (1) enter into negotiations with appropriate entities including the World Bank and GAVI Alliance to establish advanced market commitments to purchase vaccines to combat HIV/AIDS, tuberculosis, malaria, and other related infectious diseases; and (2) report to the appropriate congressional committees.

Directs the President to produce a report setting forth a strategy for vaccine development.

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

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

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

Sets forth congressional findings respecting compacts and framework agreements.

Revises annual report provisions.

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.

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(Sec. 304) 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,Sets forth provisions establishing CDCP malaria research and elimination of malaria. monitoring duties.

(Sec. 304) AmendsDirects the ActPresident to direct the President, through the Coordinator,report annually to support the development of partnerships betweenappropriate congressional committees respecting 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 inassistance for the prevention, treatment, control, and careelimination 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.malaria.

(Sec. 312) Extends from 5 years to 10 years305) Amends the annual presidential reporting requirement respectingImmigration and Nationality Act to eliminate infection with the prevention of mother-to-child HIV transmission.etiologic agent for acquired immune deficiency syndrome (AIDS) as a public health grounds for alien nonadmission.

(Sec. 313) Directs307) Amends the President to: (1) formulate a comprehensive global HIV/AIDS prevention strategy that addresses the vulnerabilities of women and youthAct to HIV infection and seeks to reduce the factors that lead to gender disparities in the raterevise requirements of HIV infection (includes among the elements of suchfive-year strategy to combat HIV/AIDS prevention education); (2) provide strategy-based guidanceas it pertains to U.S. government field missions in appropriate countries;mother-to-child transmission, care and (3) transmit such strategytreatment of family members, and guidance to the appropriate congressional committees and make such information available to the public. care for children orphaned by HIV/AIDS.

<b>Title IV: Authorization of Appropriations </b>- (Sec. 401) Authorizes appropriations(Sec. 308) Extends from 5 years to carry out10 years the Act through FY2013.annual presidential reporting requirement respecting the prevention of mother-to-child HIV transmission.

(Sec. 403) Amends309) Directs the Act respecting fund allocation provisionsCoordinator to require that: (1) 20%establish a panel of all HIV/AIDS program fundsexperts to be used for HIV prevention programs; (2)known as the Coordinator provide balanced funding for preventionPrevention of Mother-to-Child Transmission Panel to: (1) review activities for sexualto prevent mother-to-child transmission of HIV/AIDSHIV; 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(2) recommend 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.increases of mother-to-child transmission prevention services. Authorizes FY2009-FY2011 appropriations for the Panel.

Extends Directs the set-aside for assistance for orphans and vulnerable children affected by HIV/AIDS through FY2013. Panel to submit its recommendations to the appropriate congressional committees. Terminates the panel 60 days after the report's submission.

(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<b>Title IV: Funding Allocations</b> - (Sec. 401) Authorizes appropriations to another country. carry out the Act through FY2013.

<b>Title V: Sustainability and Strengthening of Health Care Systems - </b>(Sec. 501) Amends(Sec. 403) Directs the Act to add a title VI (SustainabilityCoordinator to: (1) provide balanced funding for prevention activities for sexual transmission of HIV/AIDS; (2) ensure that abstinence, delay of sexual debut, monogamy, fidelity and Strengtheningpartner reduction programs are implemented and funded in each host country's strategy; and (3) establish an HIV sexual transmission prevention strategy governing funding to prevent the sexual transmission of Health Care Systems). HIV in any host country with a generalized epidemic.

States that it shall be U.S. policy to support countries receiving U.S.Extends through FY2013, and revises, the set-aside for assistance to combat HIV/AIDS, tuberculosis, and malaria, and other health programs in developingfor orphans and implementing five-year health workforce strategies.vulnerable children affected by HIV/AIDS.

Authorizes USAID to provide technical and financialRequires that for FY2009-FY2013 more than half of appropriations for bilateral global HIV/AIDS assistance to such countries. Sets forth activities toshall be supported by such assistance.expended for: (1) antiretroviral treatment; (2) clinical monitoring of HIV-seropositive people not in need of antiretroviral treatment; (3) care for associated opportunistic infections; (4) nutrition and food support for people living with HIV/AIDS; and (5) other essential medical care for people living with HIV/AIDS.

Expresses<b>Title V: Miscellaneous </b>- (Sec. 501) Directs the senseSecretary of Congress respectingState to increase by $1 the provision of comprehensive health carefee for HIV/AIDS health care workers.processing machine readable nonimmigrant visas and machine readable combined border crossing identification cards and nonimmigrant visas by October 1, 2010, and by an additional $1 by October 1, 2013.

Directs<b>Title VI: Emergency Plan for Indian Safety and Health</b> - (Sec. 601) Establishes in the Coordinator to work withTreasury the Secretary of the Treasury to reform International MonetaryEmergency Fund (IMF) macroeconomicfor Indian Safety and fiscal policies that result in limitations on national and donor investments in health. Health.

DirectsAuthorizes appropriations to be transferred from the Coordinator to: (1) work withTreasury to the PartnershipFund 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.five-year period beginning on October 1, 2008.

Authorizes FY2009-FY2013 appropriationsDirects the Attorney General, the Secretary of the Interior, and the Secretary of Health and Human Services, in consultation with Indian tribes, to establish an emergency plan that addresses law enforcement, water, and health care needs of Indian tribes for title VI. each of FY2010-FY2019.
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== Status of the Legislation ==

<status>
Latest Major Action: 7/25/2008: Presented to President.
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== Points in Favor ==

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== Points Against ==

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