Sec. 201 Assistance to treat hydrocephalus and train surgeons
“137. Assistance to treat hydrocephalus and train surgeons
“(a) Purposes—The purposes of assistance authorized by this section are—
“(1) to ensure that life-saving treatment of hydrocephalus is an important priority of United States bilateral foreign assistance, including through promotion of innovative treatments and training of medical practitioners from the developing world in the latest treatment protocols and best practices for the treatment of hydrocephalus, including—
“(A) surgery and post-surgery care in developing countries;
“(B) the creation of a comprehensive hydrocephalus training program based in the developing world for surgeons and key members of their medical team; and
“(C) the training of medical practitioners based in the developing world in ETV/CPC and other appropriate treatment protocols; and
“(2) to promote research to reduce the incidence of PIH epidemiology, pathophysiology, and disease burden, and to improve treatment of hydrocephalus.
“(b) Authorization—To carry out the purposes of subsection (a), the President is authorized to provide assistance to support a network of trained medical practitioners to treat hydrocephalus in children at pediatric hospitals and hydrocephalus treatment centers in developing countries with a high incidence of hydrocephalus.
“(c) Activities supported
“(1) Comprehensive program
“(A) In general—Assistance provided under subsection (b) shall, to the maximum extent practicable, be used to establish a comprehensive program to administer global hydrocephalus treatment and training activities utilizing a network of pediatric hospitals capable of performing endoscopic surgery in developing countries.
“(B) Administration—The program described in subparagraph (A) shall be administered by healthcare executives and neurosurgeons with expertise in the treatment of hydrocephalus.
“(C) Responsibilities—The responsibilities of the administrators described in subparagraph (B) shall include—
“(i) developing an appropriate education and training curriculum;
“(ii) establishing quality control standards;
“(iii) instituting safety guidelines and standards; and
“(iv) developing monitoring and evaluation protocols.
“(2) Training hospital
“(A) In general—Assistance provided under subsection (b) shall, to the maximum extent practicable, be used to establish a surgeon training program within a pediatric hospital based in a developing country with a high incidence of hydrocephalus with the goal of training four surgeons annually and a total of 20 surgeons over a 5-year period to treat hydrocephalus utilizing the ETV/CPC technique.
“(B) Timeline—To the maximum extent practicable, the surgeon training program described in subparagraph (A) should be operational no later than 1 year after the date of enactment of this section.
“(C) Training admissions criteria—Candidates for the surgeon training program established under subparagraph (A) shall—
“(i) have a demonstrated commitment to providing medical assistance in the developing world; and
“(ii) certify that the candidate intends to remain and practice medicine in the developing world following completion of the program.
“(D) Training program methodology—The surgeon training program established under subparagraph (A) shall—
“(i) be conducted by a neurosurgeon with a minimum of 3 years of full-time operating experience in the developing world;
“(ii) be a hands-on operating room experience in the developing world;
“(iii) utilize a hydrocephalus treatment protocol with an emphasis on ETV/CPC as the preferred treatment when medically appropriate; and
“(iv) require that each trainee complete a minimum of 50 ETV/CPC or ETV procedures and at least 25 VP shunt procedures.
“(3) Treatment centers
“(A) In general—Assistance provided under subsection (b) shall, to the maximum extent practicable, be used to establish at least 20 hydrocephalus treatment centers located at public and private hospitals in developing countries with a high incidence of hydrocephalus, which shall include treatment costs, endoscopy equipment and medical supplies necessary to provide ETV/CPC procedures to treat hydrocephalus.
“(B) Staffing—The treatment centers described in subparagraph (A) shall be staffed by—
“(i) one or more surgeons who have successfully completed the surgeon training program provided pursuant to paragraph (2); and
“(ii) a patient care administrator.
“(C) Treatment—The treatment centers described in subparagraph (A) shall—
“(i) provide surgery to treat hydrocephalus in children;
“(ii) perform at least 50 hydrocephalus surgeries annually including a minimum of 25 ETV or ETV/CPC surgeries; and
“(iii) provide post-surgery care and support for the children treated in accordance with clause (i).
“(4) Medical records and data—Assistance provided under subsection (b) shall, to the maximum extent practicable, include the maintenance of medical records which track patient care activities and information about the causes and incidence rates of PIH.
“(d) Definitions—In this section:
“(1) CPC—The term CPC means choroid plexus cauterization, a surgical procedure to reduce the production of cerebrospinal fluid in the brain.
“(2) ETV—The term ETV means endoscopic third ventriculostomy, a shunt-less surgical procedure in which an opening is created in the floor of the third ventricle of the brain allowing cerebrospinal fluid to bypass any obstruction and flow directly to the basal cisterns.
“(3) ETV/CPC—The term ETV/CPC means the shunt-less surgical method for treating hydrocephalus through the combination of ETV and CPC surgical procedures.
“(4) Hydrocephalus—The term hydrocephalus means a medical condition in which an abnormal accumulation of cerebrospinal fluid in the ventricles or cavities of the brain causes increased intracranial pressure inside the skull and progressive enlargement of the head.
“(5) Medical practitioners—The term medical practitioners means physicians, nurses, and other clinicians, such as physical therapists.
“(6) PIH—The term PIH means post-infectious or acquired hydrocephalus which is the onset of hydrocephalus after birth due to the affects of an infection, such as meningitis, that has attacked the brain.
“(7) VP shunt—The term VP shunt means a ventriculoperitonea shunt which is a plastic tube that is regulated by a valve and surgically placed in a brain ventricle that allows the cerebrospinal fluid to flow out of the brain through the tube and into the patient’s abdomen.
“(e) Authorization of appropriations—Of the amounts made available to carry out this chapter for child survival and maternal health programs through the Bureau of Global Health of the United States Agency for International Development, there are authorized to be appropriated to the President $375,000,000 for each of the fiscal years 2019 through 2023 to carry out this section.”