PRIA, Government Policy, Made Personal

Summary

The Global AIDS Coordinator must make sure money for preventing sexual spread of HIV is split fairly and that programs that teach abstinence, delaying first sex, monogamy, fidelity, and reducing partners are meaningfully and fairly included in each host country’s prevention plan. The Coordinator must write a sexual‑transmission prevention strategy for any country with a generalized epidemic. If that strategy gives less than 50 percent of the prevention money to those behavior programs, the Coordinator must tell the appropriate congressional committees within 30 days why. New prevention technologies and programs (for example, medical male circumcision, blood‑exposure education, hospital infection investigations, pre‑exposure drugs, microbicides, counseling and testing, or mother‑to‑child prevention) are not counted when checking the 50 percent rule. Not later than 1 year after July 30, 2008, and each year after, the President must report to those committees and publish how this rule was carried out for the most recent fiscal year. For fiscal years 2009 through 2024, and for fiscal year 2025 through March 25 of that year, at least 10 percent of funds for HIV/AIDS assistance under the law must go to orphans and other vulnerable children, and at least half of that money must flow through local non‑profit nongovernmental organizations (including faith‑based groups). In those same years, more than half of the funds must be used for antiretroviral treatment, clinical monitoring of HIV‑positive people not yet needing treatment, care for opportunistic infections, nutrition and food support, and other essential medical care. For fiscal years 2009 through 2013, the treatment goal (above 2,000,000) must rise by at least the same percentage that bilateral HIV/AIDS funding increased over fiscal year 2008, may rise further only for stated reasons, and must be increased more if the average U.S. government cost per patient falls compared with fiscal year 2008; prevention and care goals must also grow according to disease data and available resources.

Title 22, §7673

Foreign Relations and Intercourse, Source: USLM XML via OLRC

(a)Balanced funding requirement

(1)In general

The Global AIDS Coordinator shall—

(A)provide balanced funding for prevention activities for sexual transmission of HIV/AIDS; and

(B)ensure that activities promoting abstinence, delay of sexual debut, monogamy, fidelity, and partner reduction are implemented and funded in a meaningful and equitable way in the strategy for each host country based on objective epidemiological evidence as to the source of infections and in consultation with the government of each host county involved in HIV/AIDS prevention activities.

(2)Prevention strategy

(A)Establishment

In carrying out paragraph (1), the Global AIDS Coordinator shall establish an HIV sexual transmission prevention strategy governing the expenditure of funds authorized under this chapter to prevent the sexual transmission of HIV in any host country with a generalized epidemic.

(B)Report

In each host country described in subparagraph (A), if the strategy established under subparagraph (A) provides less than 50 percent of the funds described in subparagraph (A) for activities promoting abstinence, delay of sexual debut, monogamy, fidelity, and partner reduction, the Global AIDS Coordinator shall, not later than 30 days after the issuance of this strategy, report to the appropriate congressional committees on the justification for this decision.

(3)Exclusion

Programs and activities that implement or purchase new prevention technologies or modalities, such as medical male circumcision, public education about risks to acquire HIV infection from blood exposures, promoting universal precautions, investigating suspected nosocomial infections, pre-exposure pharmaceutical prophylaxis to prevent transmission of HIV, or microbicides and programs and activities that provide counseling and testing for HIV or prevent mother-to-child prevention of HIV, shall not be included in determining compliance with paragraph (2).

(4)Report

Not later than 1 year after July 30, 2008, and annually thereafter as part of the annual report required under section 2151b–2(e) of this title, the President shall—

(A)submit a report on the implementation of paragraph (2) for the most recently concluded fiscal year to the appropriate congressional committees; and

(B)make the report described in subparagraph (A) available to the public.

(b)Orphans and vulnerable children

For fiscal years 2009 through 2024 and fiscal year 2025 through March 25 of such fiscal year, not less than 10 percent of the amounts appropriated or otherwise made available to carry out the provisions of section 2151b–2 of this title for HIV/AIDS assistance for each such fiscal year shall be expended for assistance for orphans and other children affected by, or vulnerable to, 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.

(c)Funding allocation

For each of the fiscal years 2009 through 2024 and for fiscal year 2025 through March 25 of such fiscal year, more than half of the amounts appropriated or otherwise made available to carry out the provisions of section 2151b–2 of this title shall be expended for— (1)

(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 HIV/AIDS-related medical care for people living with HIV/AIDS.

(d)Treatment, prevention, and care goals

For each of the fiscal years 2009 through 2013—

(1)the treatment goal under section 7672(a)(3) of this title shall be increased above 2,000,000 by at least the percentage increase in the amount appropriated for bilateral global HIV/AIDS assistance for such fiscal year compared with fiscal year 2008;

(2)any increase in the treatment goal under section 7672(a)(3) of this title above the percentage increase in the amount appropriated for bilateral global HIV/AIDS assistance for such fiscal year compared with fiscal year 2008 shall be based on long-term requirements, epidemiological evidence, the share of treatment needs being met by partner governments and other sources of treatment funding, and other appropriate factors;

(3)the treatment goal under section 7672(a)(3) of this title shall be increased above the number calculated under paragraph (1) by the same percentage that the average United States Government cost per patient of providing treatment in countries receiving bilateral HIV/AIDS assistance has decreased compared with fiscal year 2008; and

(4)the prevention and care goals established in clauses (i) and (iv) of section 2151b–2(b)(1)(A) of this title shall be increased consistent with epidemiological evidence and available resources.

Notes & Related Subsidiaries

Editorial Notes

References in Text

This chapter, referred to in subsec. (a)(2)(A), was in the original “this Act”, meaning Pub. L. 108–25, May 27, 2003, 117 Stat. 711, which is classified principally to this chapter. For complete classification of this Act to the Code, see

Short Title

note set out under section 7601 of this title and Tables.

Amendments

2024—Subsec. (b). Pub. L. 118–47, § 7072(c)(1), substituted “2024 and fiscal year 2025 through March 25 of such fiscal year” for “2023”. Subsec. (c). Pub. L. 118–47, § 7072(c)(2), substituted “2024 and for fiscal year 2025 through March 25 of such fiscal year” for “2023” in introductory provisions. 2018—Subsec. (b). Pub. L. 115–305, § 4(1), substituted “2023” for “2018”. Subsec. (c). Pub. L. 115–305, § 4(2), substituted “2023” for “2018” in introductory provisions. 2013—Subsec. (b). Pub. L. 113–56, § 6(a), substituted “2018” for “2013” and “amounts appropriated or otherwise made available to carry out the provisions of section 2151b–2 of this title” for “amounts appropriated pursuant to the authorization of appropriations under section 7671 of this title”. Subsec. (c). Pub. L. 113–56, § 6(b), substituted “2018” for “2013” and “amounts appropriated or otherwise made available to carry out the provisions of section 2151b–2 of this title” for “amounts appropriated for bilateral global HIV/AIDS assistance pursuant to section 7671 of this title” in introductory provisions. 2008—Subsec. (a). Pub. L. 110–293, § 403(1), amended subsec. (a) generally. Prior to amendment, text read as follows: “For fiscal years 2006 through 2008, not less than 55 percent of the amounts appropriated pursuant to the authorization of appropriations under section 7671 of this title for HIV/AIDS assistance for each such fiscal year shall be expended for therapeutic medical care of individuals infected with HIV, of which such amount at least 75 percent should be expended for the purchase and distribution of antiretroviral pharmaceuticals and at least 25 percent should be expended for related care. For fiscal years 2006 through 2008, not less than 33 percent of the amounts appropriated pursuant to the authorization of appropriations under section 7671 of this title for HIV/AIDS prevention consistent with section 2151b–2(d) of this title for each such fiscal year shall be expended for abstinence-until-marriage programs.” Subsec. (b). Pub. L. 110–293, § 403(2), substituted “fiscal years 2009 through 2013” for “fiscal years 2006 through 2008” and “other children affected by, or vulnerable to,” for “vulnerable children affected by”. Subsecs. (c), (d). Pub. L. 110–293, § 403(3), added subsecs. (c) and (d).

§7673 Allocation of Funds