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Title II — Using funds strategically to maximize results

H.R. 3117 · 113th Congress · Sep 17, 2013 · Lineage

II Using funds strategically to maximize results

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.
(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—
(1)
services appropriate for men who have sex with men, transgender people, people who inject drugs, and sex workers;
(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;
(3)
scalable combination of prevention and treatment approaches to HIV/AIDS;
(4)
prevention and management of co-morbidities such as tuberculosis, malaria, and viral hepatitis; and
(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.

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—
(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;
(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;
(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; and
(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.
(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.

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—
(1)
assisting developing countries create, strengthen, and implement their own evidence-based national HIV/AIDS strategies, by means that include—
(A)
supporting early diagnosis and initiation of HIV and tuberculosis treatment to achieve accelerated reductions of incidence and morbidity;
(B)
eliminating the vertical transmission of HIV from mother to child and supporting early diagnosis and initiation of HIV treatment in infants and children;
(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;
(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;
(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;
(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; and
(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;
(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;
(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;
(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;
(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; and
(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.
(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.