Part B - Assistance for Children and Families

22 USC 7651 - Findings

Congress makes the following findings:
(1) Approximately 2,000 children around the world are infected each day with HIV through mother-to-child transmission. Transmission can occur during pregnancy, labor, and delivery or through breast feeding. Over 90 percent of these cases are in developing nations with little or no access to public health facilities.
(2) Mother-to-child transmission is largely preventable with the proper application of pharmaceuticals, therapies, and other public health interventions.
(3) Certain antiretroviral drugs reduce mother-to-child transmission by nearly 50 percent. Universal availability of this drug could prevent up to 400,000 infections per year and dramatically reduce the number of AIDS-related deaths.
(4) At the United Nations Special Session on HIV/AIDS in June 2001, the United States committed to the specific goals with respect to the prevention of mother-to-child transmission, including the goals of reducing the proportion of infants infected with HIV by 20 percent by the year 2005 and by 50 percent by the year 2010, as specified in the Declaration of Commitment on HIV/AIDS adopted by the United Nations General Assembly at the Special Session.

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(5) Several United States Government agencies including the United States Agency for International Development and the Centers for Disease Control are already supporting programs to prevent mother-to-child transmission in resource-poor nations and have the capacity to expand these programs rapidly by working closely with foreign governments and nongovernmental organizations.
(6) Efforts to prevent mother-to-child transmission can provide the basis for a broader response that includes care and treatment of mothers, fathers, and other family members who are infected with HIV or living with AIDS.
(7) HIV/AIDS has devastated the lives of countless children and families across the globe. Since the epidemic began, an estimated 13,200,000 children under the age of 15 have been orphaned by AIDS, that is they have lost their mother or both parents to the disease. The Joint United Nations Program on HIV/AIDS (UNAIDS) estimates that this number will double by the year 2010.
(8) HIV/AIDS also targets young people between the ages of 15 to 24, particularly young women, many of whom carry the burden of caring for family members living with HIV/AIDS. An estimated 10,300,000 young people are now living with HIV/AIDS. One-half of all new infections are occurring among this age group.

22 USC 7652 - Policy and requirements

(a) Policy 
The United States Governments response to the global HIV/AIDS pandemic should place high priority on the prevention of mother-to-child transmission, the care and treatment of family members and caregivers, and the care of children orphaned by AIDS. To the maximum extent possible, the United States Government should seek to leverage its funds by seeking matching contributions from the private sector, other national governments, and international organizations.
(b) Requirements 
The 5-year United States Government strategy required by section 7611 of this title shall
(1) provide for meeting or exceeding the goal to reduce the rate of mother-to-child transmission of HIV by 20 percent by 2005 and by 50 percent by 2010;
(2) include programs to make available testing and treatment to HIV-positive women and their family members, including drug treatment and therapies to prevent mother-to-child transmission; and
(3) expand programs designed to care for children orphaned by AIDS.

22 USC 7653 - Annual reports on prevention of mother-to-child transmission of the HIV infection

(a) In general 
Not later than 1 year after May 27, 2003, and annually thereafter for a period of 5 years, the President shall submit to appropriate congressional committees a report on the activities of relevant executive branch agencies during the reporting period to assist in the prevention of mother-to-child transmission of the HIV infection.
(b) Report elements 
Each report shall include
(1) a statement of whether or not all relevant executive branch agencies have met the goal described in section 7652 (b)(1) of this title; and
(2) a description of efforts made by the relevant executive branch agencies to expand those activities, including
(A) information on the number of sites supported for the prevention of mother-to-child transmission of the HIV infection;
(B) the specific activities supported;
(C) the number of women tested and counseled; and
(D) the number of women receiving preventative drug therapies.
(c) Reporting period defined 
In this section, the term reporting period means, in the case of the initial report, the period since May 27, 2003, and, in the case of any subsequent report, the period since the date of submission of the most recent report.

22 USC 7654 - Pilot program of assistance for children and families affected by HIV/AIDS

(a) In general 
The President, acting through the United States Agency for International Development, should establish a program of assistance that would demonstrate the feasibility of the provision of care and treatment to orphans and other children and young people affected by HIV/AIDS in foreign countries.
(b) Program requirements 
The program should
(1) build upon and be integrated into programs administered as of May 27, 2003, by the relevant executive branch agencies for children affected by HIV/AIDS;
(2) work in conjunction with indigenous community-based programs and activities, particularly those that offer proven services for children;
(3) reduce the stigma of HIV/AIDS to encourage vulnerable children infected with HIV or living with AIDS and their family members and caregivers to avail themselves of voluntary counseling and testing, and related programs, including treatments;
(4) ensure the importance of inheritance rights of women, particularly women in African countries, due to the exponential growth in the number of young widows, orphaned girls, and grandmothers becoming heads of households as a result of the HIV/AIDS pandemic;
(5) provide, in conjunction with other relevant executive branch agencies, the range of services for the care and treatment, including the provision of antiretrovirals and other necessary pharmaceuticals, of children, parents, and caregivers infected with HIV or living with AIDS;
(6) provide nutritional support and food security, and the improvement of overall family health;
(7) work with parents, caregivers, and community-based organizations to provide children with educational opportunities; and
(8) provide appropriate counseling and legal assistance for the appointment of guardians and the handling of other issues relating to the protection of children.
(c) Report 
Not later than 18 months after May 27, 2003, the President should submit a report on the implementation of this section to the appropriate congressional committees. Such report should include a description of activities undertaken to carry out subsection (b)(4).
(d) Authorization of appropriations 

(1) In general 
In addition to amounts otherwise available for such purpose, there are authorized to be appropriated to the President, from amounts authorized to be appropriated under section 7671 of this title, such sums as may be necessary for each of the fiscal years 2004 through 2008 to carry out the program. A significant percentage of the amount appropriated pursuant to the authorization of appropriations under the preceding sentence for a fiscal year should be made available to carry out subsection (b)(4).
(2) Availability of funds 
Amounts appropriated pursuant to paragraph (1) are authorized to remain available until expended.

22 USC 7655 - Pilot program on family survival partnerships

(a) Purpose 
The purpose of this section is to authorize the President to establish a program, through a public-private partnership, for the provision of medical care and support services to HIV positive parents and their children identified through existing programs to prevent mother-to-child transmission of HIV in countries with or at risk for severe HIV epidemic with particular attention to resource constrained countries.
(b) Grants 

(1) In general 
The President is authorized to establish a program for the award of grants to eligible administrative organizations to enable such organizations to award subgrants to eligible entities to expand activities to prevent the mother-to-child transmission of HIV by providing medical care and support services to HIV infected parents and their children.
(2) Use of funds 
Amounts provided under a grant awarded under paragraph (1) shall be used
(A) to award subgrants to eligible entities to enable such entities to carry out activities described in subsection (c);
(B) for administrative support and subgrant management;
(C) for administrative data collection and reporting concerning grant activities;
(D) for the monitoring and evaluation of grant activities;
(E) for training and technical assistance for subgrantees; and
(F) to promote sustainability.
(c) Subgrants 

(1) In general 
An organization awarded a grant under subsection (b) shall use amounts received under the grant to award subgrants to eligible entities.
(2) Eligibility 
To be eligible to receive a subgrant under paragraph (1), an entity shall
(A) be a local health organization, an international organization, or a partnership of such organizations; and
(B) demonstrate to the awarding organization that such entity
(i) is currently administering a proven intervention to prevent mother-to-child transmission of HIV in countries with or at risk for severe HIV epidemic with particular attention to resource constrained countries, as determined by the President;
(ii) has demonstrated support for the proposed program from relevant government entities; and
(iii) is able to provide HIV care, including antiretroviral treatment when medically indicated, to HIV positive women, men, and children with the support of the project funding.
(3) Local health and international organizations 
For purposes of paragraph (2)(A)
(A) the term local health organization means a public sector health system, nongovernmental organization, institution of higher education, community-based organization, or nonprofit">nonprofit health system that provides directly, or has a clear link with a provider for the indirect provision of, primary health care services; and
(B) the term international organization means
(i) a nonprofit">nonprofit international entity;
(ii) an international charitable institution;
(iii) a private voluntary international entity; or
(iv) a multilateral institution.
(4) Priority requirement 
In awarding subgrants under this subsection, the organization shall give priority to eligible applicants that are currently administering a program of proven intervention to HIV positive individuals to prevent mother-to-child transmission in countries with or at risk for severe HIV epidemic with particular attention to resource constrained countries, and who are currently administering a program to HIV positive women, men, and children to provide life-long care in family-centered care programs using non-Federal funds.
(5) Selection of subgrant recipients 
In awarding subgrants under this subsection, the organization should
(A) consider applicants from a range of health care settings, program approaches, and geographic locations; and
(B) if appropriate, award not less than 1 grant to an applicant to fund a national system of health care delivery to HIV positive families.
(6) Use of subgrant funds 
An eligible entity awarded a subgrant under this subsection shall use subgrant funds to expand activities to prevent mother-to-child transmission of HIV by providing medical treatment and care and support services to parents and their children, which may include
(A) providing treatment and therapy, when medically indicated, to HIV-infected women, their children, and families;
(B) the hiring and training of local personnel, including physicians, nurses, other health care providers, counselors, social workers, outreach personnel, laboratory technicians, data managers, and administrative support personnel;
(C) paying laboratory costs, including costs related to necessary equipment and diagnostic testing and monitoring (including rapid testing), complete blood counts, standard chemistries, and liver function testing for infants, children, and parents, and costs related to the purchase of necessary laboratory equipment;
(D) purchasing pharmaceuticals for HIV-related conditions, including antiretroviral therapies;
(E) funding support services, including adherence and psychosocial support services;
(F) operational support activities; and
(G) conducting community outreach and capacity building activities, including activities to raise the awareness of individuals of the program carried out by the subgrantee, other communications activities in support of the program, local advisory board functions, and transportation necessary to ensure program participation.
(d) Reports 
The President shall require that each organization awarded a grant under subsection (b)(1) to submit an annual report that includes
(1) the progress of programs funded under this section;
(2) the benchmarks of success of programs funded under this section; and
(3) recommendations of how best to proceed with the programs funded under this section upon the expiration of funding under subsection (e).
(e) Funding 
There are authorized to be appropriated to the President, from amounts authorized to be appropriated under section 7671 of this title, such sums as may be necessary for each of the fiscal years 2004 through 2008 to carry out the program.
(f) Limitation on administrative expenses 
An organization shall ensure that not more than 7 percent of the amount of a grant received under this section by the organization is used for administrative expenses.