Post by Justin Boyd on May 5, 2008 16:54:26 GMT -5
IN THE SENATE OF THE UNITED STATES
Mr.Boyd (for himself) offers
A BILL
To authorize appropriations for fiscal years 2009 through 2013 to provide assistance to foreign countries to combat HIV/AIDS, tuberculosis, and malaria, and for other purposes.
BE IT ENACTED by the House of Representatives and the Senate of the United States.
SECTION 1. SHORT TITLE.
This bill shall be cited and known as the `Global Leadership Against Infections Diseases Act"
SECTION 2. DEFINITIONS.
(1) For the purposes of this Act, is to strengthen and enhance United States global leadership and the effectiveness of the United States response to the HIV/AIDS, tuberculosis, and malaria pandemics and other related and preventable infectious diseases in developing countriesshall refer to Global Leadership Against Infections Diseases Act
(2)
SECTION 3. FINDINGS.
Section 2 of the Global Leadership Against Infections Diseases Act"
is amended by adding at the end the following:
1.The HIV/AIDS pandemic continues to pose a major threat to the health of the global community, from the most severely-affected regions of sub-Saharan Africa and the Caribbean, to the emerging epidemics of Eastern Europe, Central Asia, South and Southeast Asia, and Latin America.
2.According to UNAIDS' 2007 global estimates, there are 33.2 million individuals with HIV/AIDS worldwide, including 2.5 million people newly-infected with HIV. Of those infected with HIV, 2.5 million are children under 15 who also account for 460,000 of the newly-infected individuals.
Sub-Saharan Africa continues to be the region most affected by the HIV/AIDS pandemic. More than 68 percent of adults and nearly 90 percent of children with HIV/AIDS live in sub-Saharan Africa, and more than 76 percent of AIDS deaths in 2007 occurred in sub-Saharan Africa.
3. Although sub-Saharan Africa carries the heaviest disease burden of HIV/AIDS, the HIV/AIDS pandemic continues to affect virtually every world region. While prevalence rates are relatively low in Eastern Europe, Central Asia, South and Southeast Asia, and Latin America, without effective prevention strategies, HIV prevalence rates could rise quickly in these regions.
4. By world region, according to UNAIDS' 2007 global estimates--
`(A) in sub-Saharan Africa, there were 22.5 million adults and children infected with HIV, up from 20.9 million in 2001, with 1.7 million new HIV infections, a 5 percent prevalence rate, and 1.6 million deaths;
`(B) in South and Southeast Asia, there were 4 million adults and children infected with HIV, up from 3.5 million in 2001, with 340,000 new HIV infections, a 0.3 percent prevalence rate, and 270,000 deaths;
`(C) in East Asia, there were 800,000 adults and children infected with HIV, up from 420,000 in 2001, with 92,000 new HIV infections, a 0.1 percent prevalence rate, and 32,000 deaths;
`(D) in Eastern and Central Europe, there were 1.6 million adults and children infected with HIV, up from 630,000 in 2001, with 150,000 new HIV infections, a 0.9 percent prevalence rate, and 55,000 deaths; and
`(E) in the Caribbean, there were 230,000 adults and children infected with HIV, up from 190,000 in 2001, with 17,000 new HIV infections, a 1 percent prevalence rate, and 11,000 deaths.
5. Tuberculosis is the number one killer of individuals with HIV/AIDS and is responsible for up to one-half of HIV/AIDS deaths in Africa.
6. The wide extent of drug resistant tuberculosis, including both multi-drug resistant tuberculosis (MDR-TB) and extensively drug resistant tuberculosis (XDR-TB), driven by the HIV/AIDS pandemic in sub-Saharan Africa, has hampered both HIV/AIDS and tuberculosis treatment services. The World Health Organization (WHO) has declared the prevalence of tuberculosis to be at emergency levels in sub-Saharan Africa.
7. Forty percent of the world's population, mostly poor, live in malarial zones, and malaria, which is highly preventable, kills more than 1 million individuals worldwide each year. Ninety percent of malaria's victims are in sub-Saharan Africa and 70 percent of malaria's victims are children under the age of 5. Additionally, hunger and malnutrition kill another 6 million individuals worldwide each year.
8. Assistance to combat HIV/AIDS must address the nutritional factors associated with the disease in order to be effective and sustainable. The World Food Program estimates that 6.4 million individuals affected by HIV will need nutritional support by 2008.
9. Women and girls continue to be vulnerable to HIV, in large part, due to gender-based cultural norms that leave many women and girls powerless to negotiate social relationships.
10. Women make up 50 percent of individuals infected with HIV worldwide. In sub-Saharan Africa, where the HIV/AIDS epidemic is most severe, women make up 57 percent of individuals infected with HIV, and 75 percent of young people infected with HIV in sub-Saharan Africa are young women ages 15 to 24.
11. Women and girls are biologically, socially, and economically more vulnerable to HIV infection. Gender disparities in the rate of HIV infection are the result of a number of factors, including the following:
`(A) Cross-generational sex with older men who are more likely to be infected with HIV, and a lack of choice regarding when and whom to marry, leading to early marriages and high rates of child marriages with older men. About one-half of all adolescent females in sub-Saharan Africa and two-thirds of adolescent females in Asia are married by age 18.
`(B) Studies show that married women and married and unmarried girls often are unable or find it difficult to negotiate the frequency and timing of sexual intercourse, ensure their partner's faithfulness, or insist on condom use. Under these circumstances, women often run the risk of being infected by husbands or male partners in societies where men in relationships have more than one partner. Behavior change is particularly important in societies in which this is a common practice.
`(C) Because young married women and girls are more likely to have unprotected sex and have more frequent sex than their unmarried peers, and women and girls who are faithful to their spouses can be placed at risk of HIV/AIDS through a husband's infidelity or prior infection, marriage is not always a guarantee against HIV infection, although it is a protective factor overall.
`(D) Social and economic inequalities based largely on gender limit access for women and girls to education and employment opportunities and prevent them from asserting their inheritance and property rights. For many women, a lack of independent economic means combines with socio-cultural practices to sustain and exacerbate their fear of abandonment, eviction, or ostracism from their homes and communities and can leave many more women trapped within relationships where they are vulnerable to HIV infection.
12. A lack of educational opportunities for women and girls is linked to younger sexual debut, earlier childhood marriage, earlier childbearing, decreased child survival, worsening nutrition, and increased risk of HIV infection.
13. High rates of gender-based violence, rape, and sexual coercion within and outside marriage contribute to high rates of HIV infection. According to the World Health Organization, between one-sixth and three-quarters of women in various countries and settings have experienced some form of physical or sexual violence since the age of 15 within or outside of marriage. Women who are unable to protect themselves from such violence are often unable to protect themselves from being infected with HIV through forced sexual contact.
14. Fear of domestic violence and the continuing stigma and discrimination associated with HIV/AIDS prevent many women from accessing information about HIV/AIDS, getting tested, disclosing their HIV status, accessing services to prevent mother-to-child transmission of HIV, or receiving treatment and counseling even when they already know they have been infected with HIV.
15. According to UNAIDS, the vulnerability of individuals involved in commercial sex acts to HIV infection is heightened by stigmatization and marginalization, limited economic options, limited access to health, social, and legal services, limited access to information and prevention means, gender-related differences and inequalities, sexual exploitation and trafficking, harmful or non-protective laws and policies, and exposure to risks associated with commercial sex acts, such as violence, substance abuse, and increased mobility.
16. Lack of access to basic HIV prevention information and education and lack of coordination with existing primary health care to reduce stigma and maximize coverage.
17. Lack of access to currently available female-controlled HIV prevention methods, such as the female condom, and lack of training on proper use of either male or female condoms.
18. High rates of other sexually transmitted infections and complications during pregnancies and childbirth.
19. An absence of functioning legal frameworks to protect women and girls and, where such frameworks exist, the lack of accountable and effective enforcement of such frameworks.
20. In addition to vulnerabilities to HIV infection, women in sub-Saharan Africa face a 1-in-13 chance of dying in childbirth compared to a 1-in-16 chance in least-developed countries worldwide, a 1-in-60 chance in developing countries, and a 1-in-4,100 chance in developed countries.
21. Due to these high maternal mortality rates and high HIV prevalence rates in certain countries, special attention is needed in these countries to help HIV-positive women safely deliver healthy babies and save women's lives.
22. Unprotected sex within or outside of marriage is the single greatest factor in the transmission of HIV worldwide and is responsible for 80 percent of new HIV infections in sub-Saharan Africa.
23. Multiple randomized controlled trials have established that male circumcision reduces a man's risk of contracting HIV by 60 percent or more. Twelve acceptability studies have found that in regions of sub-Saharan Africa where circumcision is not traditionally practiced, a majority of men want the procedure. Broader availability of male circumcision services could prevent millions of HIV infections not only in men but also in their female partners.
24.(A) Youth also face particular challenges in receiving services for HIV/AIDS.
`(B) Nearly one-half of all orphans who have lost one parent and two-thirds of those who have lost both parents are ages 12 to 17. These orphans are in particular need of services to protect themselves against sexually-transmitted infections, including HIV.
`(C) Research indicates that many youth benefit from full disclosure of medically accurate, age-appropriate information about abstinence, partner reduction, and condoms. Providing comprehensive information about HIV, including delay of sexual debut and the ABC model: `Abstain, Be faithful, use Condoms', and linking such information to health care can help improve awareness of safe sex practices and address the fact that only 1 in 3 young men and 1 in 5 young women ages 15 to 24 can correctly identify ways to prevent HIV infection.
`(D) Surveys indicate that no country has succeeded in fully educating more than one-half of its youth about the prevention and transmission of HIV.
25. According to the United Nations High Commissioner for Refugees (UNHCR), HIV/AIDS prevalence rates among refugees are generally lower than the HIV/AIDS prevalence rates for their host communities, though perceptions run counter to this fact. However, peacekeeping operations that no longer deploy HIV/AIDS-positive troops still face vulnerabilities to sexual transmission of HIV with HIV-positive individuals in refugee camps. Host countries generally do not provide HIV/AIDS prevention, treatment, and care services for refugees.
26. Continuing progress to reach the millions of impoverished individuals who need voluntary testing, counseling, treatment, and care for HIV/AIDS requires increased efforts to strengthen health care delivery systems and infrastructure, rebuild and expand the health care workforce, and strengthen allied and support services in countries receiving United States global HIV/AIDS assistance.
27. While HIV/AIDS poses the greatest health threat of modern times, it also poses the greatest development challenge for developing countries with fragile economies and weak public financial management systems that are ill equipped to shoulder the burden of this disease. International donors will have to play a critical role in providing resources for HIV/AIDS programs far into the future.
28. The emerging partnerships between countries most affected by HIV/AIDS and the United States must include stronger coordination between HIV/AIDS programs and other United States foreign assistance programs, and stronger collaboration with other donors in the areas of economic development and growth strategies.
29. The future control of HIV/AIDS demands coordination between international organizations such as the Global Fund to Fight AIDS, Tuberculosis and Malaria, UNAIDS, the World Health Organization (WHO), the World Bank and the International Monetary Fund (IMF), the international donor community, national governments, and private sector organizations, including community and faith-based organizations.
30. The future control of HIV/AIDS further requires effective and transparent public finance management systems in developing countries to advance the ability of such countries to manage public revenues and donor funds aimed at combating HIV/AIDS and other diseases.
31. The HIV/AIDS pandemic contributes to the shortage of health care personnel through loss of life and illness, unsafe working conditions, increased workloads for diminished staff, and resulting stress and burnout, while the shortage of health care personnel undermines efforts to prevent and provide care and treatment for individuals with HIV/AIDS.
32. The shortage of health care personnel, including doctors, nurses, pharmacists, counselors, laboratory staff, paraprofessionals, trained lay workers, and researchers is one of the leading obstacles to combating HIV/AIDS in sub-Saharan Africa.
33. Since 2003, important progress has been made in combating HIV/AIDS, yet there is more to be done. The number of new HIV infections is still increasing at an alarming rate. According to the United States National Institute of Allergy and Infectious Diseases, globally, for every 1 individual put on antiretroviral therapy, 6 individuals are newly infected with HIV.
34. The United States Government continues to be the world's leader in the fight against HIV/AIDS and the unsurpassed partner with developing countries in their efforts to control this disease.
35. By September 2007, the United States, through the United States Leadership Against HIV/AIDS, Tuberculosis, and Malaria Act of 2003 had provided services to prevent mother-to-child-transmission of HIV to women during 10 million pregnancies; provided antiretroviral prophylaxis for women during over 827,300 pregnancies; prevented an estimated 157,240 HIV infections in infants; cared for over 6.6 million individuals, including over 2.7 million orphans and vulnerable children; supported lifesaving antiretroviral therapies for approximately 1.4 million men, women, and children in sub-Saharan Africa, Asia, and the Carribean; and provided counseling and testing to over 33.7 million men, women, and children in developing countries.
36. These numbers were achieved because of the commitment of substantial resources and support of the United States Government to our partners on the front lines--the dedicated and committed women and men, communities, and nations who are taking control of the HIV/AIDS epidemics in their own countries.'.
SECTION 4. PROVISIONS.
The purpose of this Act is to strengthen and enhance United States global leadership and the effectiveness of the United States response to the HIV/AIDS, tuberculosis, and malaria pandemics and other related and preventable infectious diseases in developing countries by--
(1) establishing a comprehensive, integrated five-year, global strategy to fight HIV/AIDS, tuberculosis, and malaria that encompasses a plan for continued expansion and coordination of critical programs and improved coordination among relevant executive branch agencies and between the United States and foreign governments and international organizations;
(2) providing increased resources for United States bilateral efforts to combat HIV/AIDS, tuberculosis, and malaria, particularly for prevention, treatment, and care (including nutritional support), technical assistance and training, the strengthening of health care systems, health care workforce development, monitoring and evaluations systems, and operations research;
(3) providing increased resources for multilateral efforts to combat HIV/AIDS, tuberculosis, and malaria;
(4) encouraging the expansion of private sector efforts and expanding public-private sector partnerships to combat HIV/AIDS; and
(5) intensifying efforts to support the development of vaccines, microbicides, and other prevention technologies and improved diagnostics treatment for HIV/AIDS, tuberculosis, and malaria.'.
SECTION 5. ENACTMENT.
This bill shall be enacted upon the President's signature.
SECTION 6. PLAIN ENGLISH SUMMARY.
The purpose of this Act is to strengthen and enhance United States global leadership and the effectiveness of the United States response to the HIV/AIDS, tuberculosis, and malaria pandemics and other related and preventable infectious diseases in developing countries.
Mr.Boyd (for himself) offers
A BILL
To authorize appropriations for fiscal years 2009 through 2013 to provide assistance to foreign countries to combat HIV/AIDS, tuberculosis, and malaria, and for other purposes.
BE IT ENACTED by the House of Representatives and the Senate of the United States.
SECTION 1. SHORT TITLE.
This bill shall be cited and known as the `Global Leadership Against Infections Diseases Act"
SECTION 2. DEFINITIONS.
(1) For the purposes of this Act, is to strengthen and enhance United States global leadership and the effectiveness of the United States response to the HIV/AIDS, tuberculosis, and malaria pandemics and other related and preventable infectious diseases in developing countriesshall refer to Global Leadership Against Infections Diseases Act
(2)
SECTION 3. FINDINGS.
Section 2 of the Global Leadership Against Infections Diseases Act"
is amended by adding at the end the following:
1.The HIV/AIDS pandemic continues to pose a major threat to the health of the global community, from the most severely-affected regions of sub-Saharan Africa and the Caribbean, to the emerging epidemics of Eastern Europe, Central Asia, South and Southeast Asia, and Latin America.
2.According to UNAIDS' 2007 global estimates, there are 33.2 million individuals with HIV/AIDS worldwide, including 2.5 million people newly-infected with HIV. Of those infected with HIV, 2.5 million are children under 15 who also account for 460,000 of the newly-infected individuals.
Sub-Saharan Africa continues to be the region most affected by the HIV/AIDS pandemic. More than 68 percent of adults and nearly 90 percent of children with HIV/AIDS live in sub-Saharan Africa, and more than 76 percent of AIDS deaths in 2007 occurred in sub-Saharan Africa.
3. Although sub-Saharan Africa carries the heaviest disease burden of HIV/AIDS, the HIV/AIDS pandemic continues to affect virtually every world region. While prevalence rates are relatively low in Eastern Europe, Central Asia, South and Southeast Asia, and Latin America, without effective prevention strategies, HIV prevalence rates could rise quickly in these regions.
4. By world region, according to UNAIDS' 2007 global estimates--
`(A) in sub-Saharan Africa, there were 22.5 million adults and children infected with HIV, up from 20.9 million in 2001, with 1.7 million new HIV infections, a 5 percent prevalence rate, and 1.6 million deaths;
`(B) in South and Southeast Asia, there were 4 million adults and children infected with HIV, up from 3.5 million in 2001, with 340,000 new HIV infections, a 0.3 percent prevalence rate, and 270,000 deaths;
`(C) in East Asia, there were 800,000 adults and children infected with HIV, up from 420,000 in 2001, with 92,000 new HIV infections, a 0.1 percent prevalence rate, and 32,000 deaths;
`(D) in Eastern and Central Europe, there were 1.6 million adults and children infected with HIV, up from 630,000 in 2001, with 150,000 new HIV infections, a 0.9 percent prevalence rate, and 55,000 deaths; and
`(E) in the Caribbean, there were 230,000 adults and children infected with HIV, up from 190,000 in 2001, with 17,000 new HIV infections, a 1 percent prevalence rate, and 11,000 deaths.
5. Tuberculosis is the number one killer of individuals with HIV/AIDS and is responsible for up to one-half of HIV/AIDS deaths in Africa.
6. The wide extent of drug resistant tuberculosis, including both multi-drug resistant tuberculosis (MDR-TB) and extensively drug resistant tuberculosis (XDR-TB), driven by the HIV/AIDS pandemic in sub-Saharan Africa, has hampered both HIV/AIDS and tuberculosis treatment services. The World Health Organization (WHO) has declared the prevalence of tuberculosis to be at emergency levels in sub-Saharan Africa.
7. Forty percent of the world's population, mostly poor, live in malarial zones, and malaria, which is highly preventable, kills more than 1 million individuals worldwide each year. Ninety percent of malaria's victims are in sub-Saharan Africa and 70 percent of malaria's victims are children under the age of 5. Additionally, hunger and malnutrition kill another 6 million individuals worldwide each year.
8. Assistance to combat HIV/AIDS must address the nutritional factors associated with the disease in order to be effective and sustainable. The World Food Program estimates that 6.4 million individuals affected by HIV will need nutritional support by 2008.
9. Women and girls continue to be vulnerable to HIV, in large part, due to gender-based cultural norms that leave many women and girls powerless to negotiate social relationships.
10. Women make up 50 percent of individuals infected with HIV worldwide. In sub-Saharan Africa, where the HIV/AIDS epidemic is most severe, women make up 57 percent of individuals infected with HIV, and 75 percent of young people infected with HIV in sub-Saharan Africa are young women ages 15 to 24.
11. Women and girls are biologically, socially, and economically more vulnerable to HIV infection. Gender disparities in the rate of HIV infection are the result of a number of factors, including the following:
`(A) Cross-generational sex with older men who are more likely to be infected with HIV, and a lack of choice regarding when and whom to marry, leading to early marriages and high rates of child marriages with older men. About one-half of all adolescent females in sub-Saharan Africa and two-thirds of adolescent females in Asia are married by age 18.
`(B) Studies show that married women and married and unmarried girls often are unable or find it difficult to negotiate the frequency and timing of sexual intercourse, ensure their partner's faithfulness, or insist on condom use. Under these circumstances, women often run the risk of being infected by husbands or male partners in societies where men in relationships have more than one partner. Behavior change is particularly important in societies in which this is a common practice.
`(C) Because young married women and girls are more likely to have unprotected sex and have more frequent sex than their unmarried peers, and women and girls who are faithful to their spouses can be placed at risk of HIV/AIDS through a husband's infidelity or prior infection, marriage is not always a guarantee against HIV infection, although it is a protective factor overall.
`(D) Social and economic inequalities based largely on gender limit access for women and girls to education and employment opportunities and prevent them from asserting their inheritance and property rights. For many women, a lack of independent economic means combines with socio-cultural practices to sustain and exacerbate their fear of abandonment, eviction, or ostracism from their homes and communities and can leave many more women trapped within relationships where they are vulnerable to HIV infection.
12. A lack of educational opportunities for women and girls is linked to younger sexual debut, earlier childhood marriage, earlier childbearing, decreased child survival, worsening nutrition, and increased risk of HIV infection.
13. High rates of gender-based violence, rape, and sexual coercion within and outside marriage contribute to high rates of HIV infection. According to the World Health Organization, between one-sixth and three-quarters of women in various countries and settings have experienced some form of physical or sexual violence since the age of 15 within or outside of marriage. Women who are unable to protect themselves from such violence are often unable to protect themselves from being infected with HIV through forced sexual contact.
14. Fear of domestic violence and the continuing stigma and discrimination associated with HIV/AIDS prevent many women from accessing information about HIV/AIDS, getting tested, disclosing their HIV status, accessing services to prevent mother-to-child transmission of HIV, or receiving treatment and counseling even when they already know they have been infected with HIV.
15. According to UNAIDS, the vulnerability of individuals involved in commercial sex acts to HIV infection is heightened by stigmatization and marginalization, limited economic options, limited access to health, social, and legal services, limited access to information and prevention means, gender-related differences and inequalities, sexual exploitation and trafficking, harmful or non-protective laws and policies, and exposure to risks associated with commercial sex acts, such as violence, substance abuse, and increased mobility.
16. Lack of access to basic HIV prevention information and education and lack of coordination with existing primary health care to reduce stigma and maximize coverage.
17. Lack of access to currently available female-controlled HIV prevention methods, such as the female condom, and lack of training on proper use of either male or female condoms.
18. High rates of other sexually transmitted infections and complications during pregnancies and childbirth.
19. An absence of functioning legal frameworks to protect women and girls and, where such frameworks exist, the lack of accountable and effective enforcement of such frameworks.
20. In addition to vulnerabilities to HIV infection, women in sub-Saharan Africa face a 1-in-13 chance of dying in childbirth compared to a 1-in-16 chance in least-developed countries worldwide, a 1-in-60 chance in developing countries, and a 1-in-4,100 chance in developed countries.
21. Due to these high maternal mortality rates and high HIV prevalence rates in certain countries, special attention is needed in these countries to help HIV-positive women safely deliver healthy babies and save women's lives.
22. Unprotected sex within or outside of marriage is the single greatest factor in the transmission of HIV worldwide and is responsible for 80 percent of new HIV infections in sub-Saharan Africa.
23. Multiple randomized controlled trials have established that male circumcision reduces a man's risk of contracting HIV by 60 percent or more. Twelve acceptability studies have found that in regions of sub-Saharan Africa where circumcision is not traditionally practiced, a majority of men want the procedure. Broader availability of male circumcision services could prevent millions of HIV infections not only in men but also in their female partners.
24.(A) Youth also face particular challenges in receiving services for HIV/AIDS.
`(B) Nearly one-half of all orphans who have lost one parent and two-thirds of those who have lost both parents are ages 12 to 17. These orphans are in particular need of services to protect themselves against sexually-transmitted infections, including HIV.
`(C) Research indicates that many youth benefit from full disclosure of medically accurate, age-appropriate information about abstinence, partner reduction, and condoms. Providing comprehensive information about HIV, including delay of sexual debut and the ABC model: `Abstain, Be faithful, use Condoms', and linking such information to health care can help improve awareness of safe sex practices and address the fact that only 1 in 3 young men and 1 in 5 young women ages 15 to 24 can correctly identify ways to prevent HIV infection.
`(D) Surveys indicate that no country has succeeded in fully educating more than one-half of its youth about the prevention and transmission of HIV.
25. According to the United Nations High Commissioner for Refugees (UNHCR), HIV/AIDS prevalence rates among refugees are generally lower than the HIV/AIDS prevalence rates for their host communities, though perceptions run counter to this fact. However, peacekeeping operations that no longer deploy HIV/AIDS-positive troops still face vulnerabilities to sexual transmission of HIV with HIV-positive individuals in refugee camps. Host countries generally do not provide HIV/AIDS prevention, treatment, and care services for refugees.
26. Continuing progress to reach the millions of impoverished individuals who need voluntary testing, counseling, treatment, and care for HIV/AIDS requires increased efforts to strengthen health care delivery systems and infrastructure, rebuild and expand the health care workforce, and strengthen allied and support services in countries receiving United States global HIV/AIDS assistance.
27. While HIV/AIDS poses the greatest health threat of modern times, it also poses the greatest development challenge for developing countries with fragile economies and weak public financial management systems that are ill equipped to shoulder the burden of this disease. International donors will have to play a critical role in providing resources for HIV/AIDS programs far into the future.
28. The emerging partnerships between countries most affected by HIV/AIDS and the United States must include stronger coordination between HIV/AIDS programs and other United States foreign assistance programs, and stronger collaboration with other donors in the areas of economic development and growth strategies.
29. The future control of HIV/AIDS demands coordination between international organizations such as the Global Fund to Fight AIDS, Tuberculosis and Malaria, UNAIDS, the World Health Organization (WHO), the World Bank and the International Monetary Fund (IMF), the international donor community, national governments, and private sector organizations, including community and faith-based organizations.
30. The future control of HIV/AIDS further requires effective and transparent public finance management systems in developing countries to advance the ability of such countries to manage public revenues and donor funds aimed at combating HIV/AIDS and other diseases.
31. The HIV/AIDS pandemic contributes to the shortage of health care personnel through loss of life and illness, unsafe working conditions, increased workloads for diminished staff, and resulting stress and burnout, while the shortage of health care personnel undermines efforts to prevent and provide care and treatment for individuals with HIV/AIDS.
32. The shortage of health care personnel, including doctors, nurses, pharmacists, counselors, laboratory staff, paraprofessionals, trained lay workers, and researchers is one of the leading obstacles to combating HIV/AIDS in sub-Saharan Africa.
33. Since 2003, important progress has been made in combating HIV/AIDS, yet there is more to be done. The number of new HIV infections is still increasing at an alarming rate. According to the United States National Institute of Allergy and Infectious Diseases, globally, for every 1 individual put on antiretroviral therapy, 6 individuals are newly infected with HIV.
34. The United States Government continues to be the world's leader in the fight against HIV/AIDS and the unsurpassed partner with developing countries in their efforts to control this disease.
35. By September 2007, the United States, through the United States Leadership Against HIV/AIDS, Tuberculosis, and Malaria Act of 2003 had provided services to prevent mother-to-child-transmission of HIV to women during 10 million pregnancies; provided antiretroviral prophylaxis for women during over 827,300 pregnancies; prevented an estimated 157,240 HIV infections in infants; cared for over 6.6 million individuals, including over 2.7 million orphans and vulnerable children; supported lifesaving antiretroviral therapies for approximately 1.4 million men, women, and children in sub-Saharan Africa, Asia, and the Carribean; and provided counseling and testing to over 33.7 million men, women, and children in developing countries.
36. These numbers were achieved because of the commitment of substantial resources and support of the United States Government to our partners on the front lines--the dedicated and committed women and men, communities, and nations who are taking control of the HIV/AIDS epidemics in their own countries.'.
SECTION 4. PROVISIONS.
The purpose of this Act is to strengthen and enhance United States global leadership and the effectiveness of the United States response to the HIV/AIDS, tuberculosis, and malaria pandemics and other related and preventable infectious diseases in developing countries by--
(1) establishing a comprehensive, integrated five-year, global strategy to fight HIV/AIDS, tuberculosis, and malaria that encompasses a plan for continued expansion and coordination of critical programs and improved coordination among relevant executive branch agencies and between the United States and foreign governments and international organizations;
(2) providing increased resources for United States bilateral efforts to combat HIV/AIDS, tuberculosis, and malaria, particularly for prevention, treatment, and care (including nutritional support), technical assistance and training, the strengthening of health care systems, health care workforce development, monitoring and evaluations systems, and operations research;
(3) providing increased resources for multilateral efforts to combat HIV/AIDS, tuberculosis, and malaria;
(4) encouraging the expansion of private sector efforts and expanding public-private sector partnerships to combat HIV/AIDS; and
(5) intensifying efforts to support the development of vaccines, microbicides, and other prevention technologies and improved diagnostics treatment for HIV/AIDS, tuberculosis, and malaria.'.
SECTION 5. ENACTMENT.
This bill shall be enacted upon the President's signature.
SECTION 6. PLAIN ENGLISH SUMMARY.
The purpose of this Act is to strengthen and enhance United States global leadership and the effectiveness of the United States response to the HIV/AIDS, tuberculosis, and malaria pandemics and other related and preventable infectious diseases in developing countries.
