article: SECTION 1. SHORT TITLE. This Act may be cited as the ``Humanitarian Assistance to Combat HIV/AIDS in sub-Saharan Africa and the Caribbean and National Security Act of 2003''. SEC. 2. FINDINGS. Congress makes the following findings: (1) The National Security Strategy of the United States, dated September 17, 2002, states: ``[I]n Africa, promise and opportunity sit side-by-side with disease, war and desperate poverty. This threatens both a core value of the United States preserving human dignity and our strategic priority combating global terror. American interests and American principles, therefore, lead in the same direction: we will work with others for an African continent that lives in liberty, peace, and growing prosperity.''. (2) On March 19, 2002, the Director of Central Intelligence testified before Congress that ``[T]he chronic problems of sub- Saharan Africa make it, too, fertile ground for direct and indirect threats to United States interests. Governments without accountability and natural disasters have left Africa with the highest concentration of human misery in the world.''. (3) Sub-Saharan Africa has been far more severely affected by HIV/AIDS than any other part of the world. In fact, AIDS has surpassed malaria as the leading cause of death in sub-Saharan Africa, and it kills many times more people than Africa's armed conflicts. (4) Africa, where an estimated 3,500,000 people were newly infected with HIV in 2002, has approximately 10 percent of the world's population but more than 70 percent of the worldwide total of people infected with HIV. (5) In November 2002, the Joint United Nations Programme on HIV/AIDS (UNAIDS) reported that in 2002, 29,400,000 people were living with HIV/AIDS in sub-Saharan Africa, an increase from 28,500,000 people in 2001. (6) At the end of 2001, an estimated 21,500,000 Africans had lost their lives to AIDS, including an estimated 2,200,000 individuals who died in that year. UNAIDS estimates that by 2020, an additional 55,000,000 Africans will lose their lives to the epidemic. (7) The HIV/AIDS epidemic in Africa is having a much greater impact on children than is the case in other parts of the world. (8) According to UNAIDS, more than 600,000 African infants become infected with HIV each year through mother-to-child transmission, either at birth or through breast-feeding. These children have short life expectancies, and the number currently alive may be about 1,000,000 children. (9) In 2001, an estimated 11,000,000 children who became orphans by AIDS were living in Africa. (10) Because of the stigma attached to AIDS, children who become orphans by AIDS are at high risk for being malnourished, abused, and denied an education. (11) According to UNAIDS, women make up an estimated 58 percent of the HIV-positive adult population in sub-Saharan Africa, as compared to 50 percent of the HIV-positive adult population worldwide. (12) Young women are particularly at risk. In 2001, an estimated 6 to 11 percent of African women aged 15 to 24 were HIV-positive, compared to 3 to 6 percent of young men. (13)(A) The HIV-infection rate among adults is approximately 8.8 percent in Africa, compared with 1.2 percent worldwide. The HIV/AIDS epidemic in sub-Saharan Africa is a major component of this African crisis. (B) In 7 sub-Saharan African countries, 20 percent or more of the adult population is infected with HIV, and the rate has reached 38.8 percent in Botswana. (C) Moreover, in Cameroon, a West African country, the adult HIV-infection rate has increased from 4.7 percent in 1996 to 11.8 percent in 2001. (D) In Nigeria, with a population that exceeds 125,000,000, an estimated 5.8 percent of adults were HIV-positive in 2001, and infection rates in some areas of Nigeria have reached levels seen in neighboring Cameroon. (14) Nongovernmental organizations working in Africa, donor governments, and African governments have responded to the HIV/ AIDS epidemic primarily by attempting to reduce the number of new HIV infections, and to some degree, by trying to ameliorate the damage done by AIDS to families, societies, and economies. (15)(A) A 1999 United Nations study found that community- based organizations, sometimes with the support of nongovernmental organizations, have emerged to supply additional labor, home care for the sick, house repair, and other services to AIDS-afflicted families. (B) Programs and projects aimed at combating the epidemic typically provide information on how HIV is spread, and on how it can be avoided, through the media, posters, lectures, and skits. AIDS awareness programs can be found in many African schools and increasingly in the workplace, where employers are recognizing their interest in reducing the HIV-infection rate among their employees. (16) Public-private partnerships have also become an important vehicle for responding to the HIV/AIDS pandemic in Africa. (17)(A) The United States Agency for International Development estimates that in fiscal year 2000, all donors and lending agencies, together with African governments, spent approximately $500,000,000 in combating HIV/AIDS, but donors have committed to increasing this amount. (B) On July 23, 2000, leaders at the G-8 world economic summit in Okinawa, Japan, pledged to reduce the number of young people infected with the HIV virus by 25 percent. (18) The World Health Organization estimates that a pledge by the G-8 countries to combat malaria and tuberculosis, and reduce the HIV virus in Africa by 25 percent, would cost at least $5,000,000,000 per year for 5 years. The World Bank launched its Multi-Country HIV/AIDS Program (MAP) for Africa in September 2000, and a World Bank official said in October 2002 that to date, $1,000,000,000 had been committed. (19) On December 9, 2001, Peter Piot, Executive Director of UNAIDS, told an international AIDS conference in Burkina Faso that assistance to fight HIV/AIDS in sub-Saharan Africa should be increased ``many-fold'', and that the region requires $5,000,000,000 per year to confront the HIV/AIDS pandemic. (20) While the AIDS epidemic in Caribbean countries does not compare to the severity of the epidemic in Africa, there are an estimated 420,000 people living with AIDS in Caribbean countries. Moreover, the HIV/AIDS adult prevalence rate in several countries in the Caribbean is among the highest outside of sub-Saharan Africa. (21) Caribbean countries with the highest prevalence of HIV infection rates are Haiti and the Bahamas, with adult HIV infection rates at more than 4 percent. Overall, an estimated 1 out of 50 people in Caribbean countries is infected with HIV. Haiti and the Dominican Republic, with a combined 340,000 adults and children living with HIV/AIDS, account for approximately 87 percent of the infected population of Caribbean countries. As noted by the United States Agency for International Development, Haiti's poverty, civil conflict, and unstable governance have contributed to the rapid spread of AIDS. In some urban areas of Haiti, HIV infection rates are at more than 10 percent of the population. (22) In Caribbean countries, access to treatment and care is non-existent for many infected with HIV. Nevertheless, many projects demonstrate that even in severely impoverished countries with little health infrastructure, there can be sustained treatment for people with HIV/AIDS. SEC. 3. SENSE OF CONGRESS. It is the sense of Congress that-- (1) effectively addressing the HIV/AIDS problem in countries in sub-Saharan Africa and the Caribbean is a moral issue of the greatest magnitude and is in the national security interest of the United States; and (2) the President should enter into direct talks with the governments of other member countries of the G-8 and member countries of the European Union to increase the amount of financial support to combat the HIV/AIDS pandemic in sub- Saharan Africa and the Caribbean. SEC. 4. GRANTS TO COMBAT HIV/AIDS IN SUB-SAHARAN AFRICA AND CARIBBEAN COUNTRIES. The Administrator of the United States Agency for International Development is authorized to award grants to nongovernmental organizations for the prevention, treatment, and control of HIV/AIDS in countries in sub-Saharan Africa and Caribbean countries, including by expanding activities to prevent the mother-to-child transmission of HIV by providing treatment, medical care, and support services to HIV- infected parents and their children. In carrying out the preceding sentence, it is the sense of Congress that the Secretary of Health and Human Services, acting through the Director of the Centers for Disease Control and Prevention, should provide appropriate medical and technical expertise to the Administrator and recipient governments. SEC. 5. APPOINTMENT OF HEALTH OFFICERS TO UNITED STATES EMBASSIES IN SUB-SAHARAN AFRICA AND THE CARIBBEAN. The Secretary of State, in conjunction with the Secretary of Health and Human Services, is authorized to appoint to the country team in each United States embassy in sub-Saharan Africa and the Caribbean a health officer to advise the United States Ambassador and assist in coordination of the effort to combat HIV/AIDS with local governments. SEC. 6. AUTHORIZATION OF APPROPRIATIONS. (a) In General.--There are authorized to be appropriated to carry out this Act $500,000,000 for each of the fiscal years 2004 through 2008. (b) Availability.--Amounts appropriated pursuant to the authorization of appropriations under subsection (a) are authorized to remain available until expended. SEC. 7. DEFINITIONS. In this Act: (1) AIDS.--The term ``AIDS'' means acquired immune deficiency syndrome. (2) Caribbean countries.--The term ``Caribbean countries'' means the countries described in section 212(b) of the Caribbean Basin Economic Recovery Act (19 U.S.C. 2702(b)). (3) HIV.--The term ``HIV'' means the human immunodeficiency virus, the pathogen that causes AIDS. (4) HIV/AIDS.--The term ``HIV/AIDS'' means, with respect to an individual, an individual who is infected with HIV or living with AIDS. (5) Countries in sub-saharan africa.--The term ``countries in sub-Saharan Africa'' has the meaning given such term in section 107 of the African Growth and Opportunity Act (19 U.S.C. 3706).
summary: Humanitarian Assistance to Combat HIV/AIDS in sub-Saharan Africa and the Caribbean and National Security Act of 2003 - Declares the sense of Congress that: (1) effectively addressing the HIV/AIDS problem in countries in sub-Saharan Africa and the Caribbean is a moral issue of the greatest magnitude and is in the national security interest of the United States; and (2) the President should enter into direct talks with the governments of other member countries of the G-8 and member countries of the European Union to increase the amount of financial support to combat the HIV/AIDS pandemic in sub-Saharan Africa and the Caribbean. Authorizes the Administrator of the United States Agency for International Development (USAID) to award grants to nongovernmental organizations (NGOs) for the prevention, treatment, and control of HIV/AIDS in countries in sub-Saharan Africa and Caribbean countries, including treatment, medical care, and support services to HIV-infected parents and their children. Expresses the sense of Congress that the Secretary of Health and Human Services (HHS), acting through the Director of the Centers for Disease Control and Prevention, should provide appropriate medical and technical expertise to the Administrator and recipient governments. Authorizes the Secretary of State, in conjunction with the Secretary of HHS, to appoint to the country team in each U.S. embassy in sub-Saharan Africa and the Caribbean a health officer to advise the U.S. Ambassador and assist in coordination of the effort to combat HIV/AIDS with local governments.