H.R.3117 - Ending the HIV/AIDS Epidemic Act of 2013
To bring an end to the spread of HIV/AIDS in the United States and around the world.
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Ms. LEE of California introduced the following bill; which was referred to the Committee on Foreign Affairs, and in addition to the Committee on Ways and Means, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concernedCommentsClose CommentsPermalink
SECTION 1. SHORT TITLE; TABLE OF CONTENTS.
TITLE I--GLOBAL HIV/AIDS-FREE GENERATION STRATEGY
TITLE II--USING FUNDS STRATEGICALLY TO MAXIMIZE RESULTS
TITLE III--ADDRESSING LEGAL AND POLICY BARRIERS TO ACCESSING HEALTH CARE
Subtitle A--General Provisions
Subtitle B--Repeal of Certain Provisions of
Public Law 108-25
SEC. 2. STATEMENT OF POLICY.
(1) expand access to lifesaving antiretroviral therapy for people living with HIV/AIDS and immediately link people to continuous and coordinated high-quality care when they learn they are infected with HIV;CommentsClose CommentsPermalink
(2) expand targeted efforts to prevent HIV infection using a combination of effective, evidence-based approaches, including the elimination of new pediatric HIV infections worldwide, routine HIV screening, and universal access to HIV prevention tools in the communities where HIV/AIDS is most heavily concentrated;CommentsClose CommentsPermalink
SEC. 3. FINDINGS.
(2) Developing countries continue to bear the brunt of the HIV/AIDS epidemic, with sub-Saharan Africa accounting for 68 percent of all adults and children living with HIV/AIDS, 59 percent of whom are female.CommentsClose CommentsPermalink
(4) HIV prevalence among young people aged 15 to 24 has declined in many countries most impacted by HIV; nevertheless, young people still account for 42 percent of all new infections among individuals aged 15 and older.CommentsClose CommentsPermalink
(5) A substantial number of HIV-positive women in HIV care and treatment programs or prevention of mother-to-child transmission (PMTCT) programs experience an unplanned pregnancy.CommentsClose CommentsPermalink
(6) Making contraceptive services more widely available through HIV care, treatment, and PMTCT programs would make it easier for women to coordinate their HIV-related care with their pregnancy prevention goals, and at the same time, help prevent mother-to-child HIV transmission.CommentsClose CommentsPermalink
(7) In 2008, the Tom Lantos and Henry J. Hyde United States Global Leadership Against HIV/AIDS, Tuberculosis, and Malaria Reauthorization Act was enacted into law, reauthorizing the President’s Emergency Plan for AIDS Relief (PEPFAR) and continued United States participation and contributions to the Global Fund to Fight AIDS, Tuberculosis and Malaria.CommentsClose CommentsPermalink
(8) The United States President’s Emergency Plan for AIDS Relief (PEPFAR), which represents the largest commitment by any nation to combat a single disease, has saved the lives of millions of people around the world by establishing and expanding the infrastructure necessary to deliver prevention, care, and treatment services in low-resource settings.CommentsClose CommentsPermalink
(9) Early detection and treatment of HIV can have significant positive health effects. New research demonstrates conclusively that treatment of individuals not only slows disease progression, but can also reduce the risk of transmission to other individuals by 96 percent.CommentsClose CommentsPermalink
(10) In most countries HIV is a disease that discriminates, disproportionately affecting society’s most vulnerable. Even in generalized epidemics in which a significant share of the wider population is living with HIV/AIDS, people in vulnerable communities often have considerably higher rates of HIV infection.CommentsClose CommentsPermalink
(11) Reaching men who have sex with men, transgender people, people who inject drugs, sex workers, and other vulnerable populations with effective HIV prevention and treatment is critical to bringing the AIDS epidemic under control.CommentsClose CommentsPermalink
(12) In February 2013, the Institute of Medicine releases a report evaluating PEPFAR and found that PEPFAR, which has provided care and treatment for more than 5 million people, has been ‘globally transformative’, a ‘lifeline’ that is ‘restoring hope’.CommentsClose CommentsPermalink
SEC. 101. GLOBAL HIV/AIDS-FREE GENERATION STRATEGY.
(a) Strategy- The President, acting through the Coordinator of United States Government Activities to Combat HIV/AIDS Globally, shall establish a comprehensive, integrated, 5-year strategy to expand and improve efforts to combat global HIV/AIDS, while promoting efficiency and maximizing results. The strategy shall be referred to as the ‘Global HIV/AIDS-Free Generation Strategy’.CommentsClose CommentsPermalink
(3) strengthen existing and future compacts and framework agreements authorized under section 104A(d)(8) of the Foreign Assistance Act of 1961 (
(B) encourage and assist national governments to pursue policies and legal frameworks that facilitate and enable effective responses to HIV prevention, care, and treatment services; andCommentsClose CommentsPermalink
(C) intensify efforts to expand access to voluntarily medical male circumcision, male and female condoms and other proven-effective HIV prevention interventions, in combination with other evidence-based modalities and structural interventions;CommentsClose CommentsPermalink
(E) increase gender equity in HIV/AIDS programs and services, including access to voluntary family planning and reproductive health services and reducing violence and coercion;CommentsClose CommentsPermalink
(G) provide capacity development support to increase meaningful engagement of civil society, especially local indigenous organizations, that work in the areas of human rights, women’s and young people’s health and rights, and gay, lesbian, bisexual, and transgender rights, in the development, implementation, monitoring, and evaluation of United States-funded programs;CommentsClose CommentsPermalink
(H) advance the efforts of developing countries to develop health systems capable of managing their epidemics, respond to broader health needs impacting affected communities, and address new and emerging health concerns; andCommentsClose CommentsPermalink
(c) Consultation- In developing the strategy, the President, acting through the Coordinator of United States Government Activities to Combat HIV/AIDS Globally, shall consult with--CommentsClose CommentsPermalink
(2) personnel at United States embassies and country missions involved in the administration of the types of United States foreign assistance described in paragraph (1);CommentsClose CommentsPermalink
(4) civil society and nongovernmental organizations engaged in improving health care and health outcomes in developing countries, including indigenous community and faith-based organizations;CommentsClose CommentsPermalink
(5) international organizations engaged in improving health care and health outcomes in developing countries and of which the United States is a voting member, with which the United States coordinates the delivery of foreign assistance, or to which the United States contributes funding for the purpose of providing such assistance;CommentsClose CommentsPermalink
(6) academic organizations, private foundations, businesses, and other organizations engaged in improving health care and health outcomes in developing countries and not receiving United States funding for such purposes;CommentsClose CommentsPermalink
(d) Report- Not later than 1 year after the date of the enactment of this Act, the President shall submit to Congress a report that sets forth the strategy described in this section.CommentsClose CommentsPermalink
SEC. 201. SUPPORT FOR OPERATIONS RESEARCH TO IMPROVE PROGRAM DELIVERY, EFFICIENCY, IMPACT, AND EFFECTIVENESS.
(a) Sense of Congress- It is the sense of the Congress that there is a need and urgency to expand the range of interventions for preventing the transmission of HIV, including behavioral prevention research, operations research to optimize combination HIV prevention, and research on medical technology to prevent HIV infection, including microbicides, cost-effective female condoms, Pre-Exposure Prophylaxis (PrEP), multipurpose technologies for the prevention of HIV and unintended pregnancy, and vaccines.CommentsClose CommentsPermalink
(b) Statement of Policy- It should be the policy of the United States to ensure that efforts to combat HIV/AIDS globally should expand, intensify, and coordinate operations research to improve the quality, delivery, and impact of programming, including with respect to--CommentsClose CommentsPermalink
(2) structural interventions to remove barriers that inhibit effective implementation of HIV/AIDS-related foreign assistance, including the analysis of laws and policies that have a negative health impact and put individuals at increased risk of HIV infection;CommentsClose CommentsPermalink
(5) identification and follow up of HIV-positive infants and children in resource-limited settings to increase the proportion of children accessing HIV treatment and care services.CommentsClose CommentsPermalink
SEC. 202. INCREASING COORDINATION AND INTEGRATION OF HIV/AIDS PROGRAMS WITH DEVELOPMENT PROGRAMS.
(a) Statement of Policy- It should be the policy of the United States to ensure that efforts to combat HIV/AIDS globally should maximize efficiencies and the integration of services and programs to achieve reduction in HIV transmission rates and the burden of HIV-related morbidity and mortality, by means that include--CommentsClose CommentsPermalink
(1) ensuring that women and adolescent girls with HIV or who are at risk of HIV infection and who do not wish to become pregnant have access to voluntary contraceptive services, including a range of contraceptive options, and voluntary counseling to plan families, either directly or through meaningful referrals to existing United States Agency for International Development or local family planning programs that provide counseling and a range of contraceptive options;CommentsClose CommentsPermalink
(2) integrating tuberculosis interventions with HIV services, including case-finding and tuberculosis treatment, expanding tuberculosis preventive therapy, and reducing other opportunistic infections that accompany HIV/AIDS;CommentsClose CommentsPermalink
(3) ensuring young people with HIV are provided with confidential and affordable access to youth-friendly comprehensive sexual and reproductive health services and supplies, including male and female condoms for the prevention of pregnancy and sexually transmitted diseases, as relevant; andCommentsClose CommentsPermalink
(4) working to promote and protect the human rights of people living with HIV, including men who have sex with men, transgender people, people who inject drugs, sex workers, and other vulnerable populations, including indigenous people, migrants, internally displaced people, young people, incarcerated populations, and people with disabilities.CommentsClose CommentsPermalink
(b) Report- Not later than 180 days after the date of the enactment of this Act, the Secretary of State shall submit to the appropriate congressional committees a report describing the utilization of efficiencies in the delivery of HIV/AIDS treatment services within and between United States-funded bilateral and multilateral programs and partner countries, including to the extent that such gains in efficiencies are being exhausted.CommentsClose CommentsPermalink
SEC. 203. INCREASING PROGRAM EFFECTIVENESS AND SUSTAINABILITY TO ACHIEVE SUCCESSFUL COUNTRY OWNERSHIP.
(a) Statement of Policy- It should be the policy of the United States to ensure that efforts to combat HIV/AIDS globally should help developing countries significantly decrease the burden of HIV, strengthen and improve their health systems, help build country ownership, and increase financial accountability to ensure sustainability and equitable access to health services, including by--CommentsClose CommentsPermalink
(C) intensifying efforts to expand access to voluntary medical male circumcision, male and female condoms, harm reduction services, and other proven-effective HIV prevention interventions, in combination with other evidence-based modalities, including structural interventions;CommentsClose CommentsPermalink
(D) intensifying efforts to eliminate HIV infections among populations that are often at greatest risk, including sex workers, men who have sex with men, transgender individuals, and people who inject drugs, and addressing the HIV-related needs, including access to ART, of those already infected;CommentsClose CommentsPermalink
(E) ensuring young people are provided with comprehensive knowledge, skill-building programs, in and out of school, to make informed and responsible decisions for their sexual health, and are provided with confidential and affordable access to youth-friendly comprehensive sexual and reproductive health services and supplies, including male and female condoms;CommentsClose CommentsPermalink
(F) ensuring women with HIV or who are at risk of HIV infection and who do not wish to become pregnant have access to voluntary contraceptive services and commodities, and women who desire pregnancy have access to family planning counseling and maternal health services free of judgment and discrimination; andCommentsClose CommentsPermalink
(G) encouraging policy changes to eliminate discriminatory and stigmatizing polices that stand in the way of access to health services by marginalized and poor populations including punitive laws against HIV exposure and potential transmission, sex work, same-sex behavior, drug use, and gender expression;CommentsClose CommentsPermalink
(2) supporting meaningful community involvement and participation, inclusive of poor, vulnerable, or marginalized populations and their representative indigenous and civil society organizations, in decisionmaking related to national HIV/AIDS strategies and the delivery of health services, including in decisions related to the adoption of health policies and the total amount and distribution of health funding;CommentsClose CommentsPermalink
(3) assisting countries to coordinate, regulate, and harmonize the delivery of health services provided by the United States and nongovernmental organizations, including community and faith-based organizations, private foundations, international organizations, and other donors, and to coordinate or integrate such services with the health system to the maximum extent practicable;CommentsClose CommentsPermalink
(4) using, to the maximum extent practicable, local and regional entities for the provision of technical assistance, and where the capacity of such entities is insufficient, supporting capacity building to enable such entities to provide such assistance;CommentsClose CommentsPermalink
(5) strengthening procurement and supply chain logistics to help prevent drug and commodity stock outs, including male and female condom shortages, and to help ensure the eventual provision of microbicides for HIV prevention; andCommentsClose CommentsPermalink
(6) providing technical assistance and support to national ministries of health, or their equivalents, and other relevant ministries in overseeing the health systems of their countries and monitoring and evaluating the effectiveness of such systems in reducing mortality and improving health outcomes, including preparing for the provision of HIV/AIDS, voluntary family planning, non-communicable diseases, and reproductive health services in emergency situations.CommentsClose CommentsPermalink
(b) Report- Not later than 180 days after the date of the enactment of this Act, the Secretary of State shall submit to the appropriate congressional committees a report identifying benchmarks that are directly relevant to significantly decreasing the burden of the epidemic in each country receiving HIV-related foreign assistance and provide context for helping countries and civil society to build country ownership.CommentsClose CommentsPermalink
SEC. 301. SUPPORT FOR LAWS AND REGULATIONS THAT IMPROVE HEALTH OUTCOMES AND PROMOTE HUMAN RIGHTS.
It should be the policy of the United States to ensure that United States foreign assistance should encourage and assist national governments of developing countries to pursue policies and legal frameworks that improve health outcomes, including policies and legal frameworks that--CommentsClose CommentsPermalink
(2) promote and improve the status of women and youth, ensuring their ability to access and use health services without fear or risk of gender-based violence, reprisal, discrimination, stigmatization, arrest, or other mistreatment;CommentsClose CommentsPermalink
(3) work to remove criminalization of, stigmatization of, and discrimination against poor, vulnerable, or marginalized populations and enact laws and policies to promote and protect the rights of such populations;CommentsClose CommentsPermalink
SEC. 302. INTENSIFYING EFFORTS TO ESTABLISH EFFECTIVE PROGRAMS FOR ENGAGING KEY AFFECTED POPULATIONS.
It should be the policy of the United States to ensure that efforts to combat HIV/AIDS globally should intensify efforts to establish effective programs for engaging men who have sex with men, transgender people, people who inject drugs, and sex workers in HIV prevention, care, and treatment initiatives, by means that include--CommentsClose CommentsPermalink
(4) defending human rights and inherent dignity by addressing laws and practices that prevent people from accessing services and providing legal and social services to individuals and communities to facilitate access to services and to reduce violence, stigma, and discrimination.CommentsClose CommentsPermalink
SEC. 303. ENSURING UNITED STATES TRADE POLICY DOES NOT RESTRICT ACCESS TO AFFORDABLE MEDICINES.
In administering title III of the Trade Act of 1974 (
(2) provides intellectual property protection consistent with the Agreement on Trade-Related Aspects of Intellectual Property Rights referred to in section 101(d)(15) of the Uruguay Round Agreements Act (
SEC. 311. REPEAL OF ‘CONSCIENCE CLAUSE’ REQUIREMENT FOR ELIGIBILITY FOR ASSISTANCE.
SEC. 312. REPEAL OF LIMITATION ON USE OF FUNDS FOR ASSISTANCE FOR SEX WORKERS.
Section 301 of the United States Leadership Against HIV/AIDS, Tuberculosis, and Malaria Act of 2003 (
SEC. 313. REPEAL OF REPORTING REQUIREMENT ON ACTIVITIES PROMOTING ABSTINENCE AND RELATED ACTIVITIES.
SEC. 314. EFFECTIVE DATE.
(2) apply with respect to funds made available to carry out the United States Leadership Against HIV/AIDS, Tuberculosis, and Malaria Act of 2003 or any amendment made by that Act on or after such date of enactment.CommentsClose CommentsPermalink