107th Congress

Global Access to HIV/AIDS Prevention, Awareness, Education, and Treatment

H.R. 2069, H. Report 107-137, and S. 2649

Background

Representative Henry J. Hyde (R-IL) introduced H.R. 2069 to amend the Foreign Assistance Act of 1961 to authorize assistance to prevent, treat, and monitor HIV/AIDS in sub-Saharan African and other developing countries. Senator Edward M. Kennedy (D-MA) introduced S. 2649, the International AIDS Treatment and Prevention Act, to provide assistance to combat the HIV/AIDS pandemic in developing countries. Like many other HIV/AIDS bills introduced in the 107th Congress, H.R. 2069 and S. 2649 sought to convey continuing congressional interest in the global HIV/AIDS epidemic and its impact on developing nations.

Provisions of the Legislation/Impact on NIH

H.R. 2069-The Global Access to HIV/AIDS Prevention, Awareness, Education, and Treatment Act of 2001

As introduced, H.R. 2069 contained no provisions that might have had an impact on research programs. During Committee action, however, an amendment containing additional provisions was adopted. Although the focus remained on providing substantial bilateral and multilateral assistance to combat the HIV/AIDS pandemic, the reported H.R. 2069 would have required the President to establish an interagency task force to ensure coordination of all Federal programs related to the prevention, treatment, and surveillance of HIV/AIDS in foreign countries. This task force would have:

• Reviewed all such Federal programs to ensure proper coordination and compatibility of activities and policies.
• Exchanged information regarding the design and impact of these programs to ensure that the U.S. Government can catalog best practices and ultimately improve program effectiveness in the countries in which they operate.
• Fostered communications between the United States and foreign nongovernmental organizations to determine how U.S. programs can be improved.

Membership on this task force would have comprised the Secretaries of State, of Defense, and of Health and Human Services (HHS); Administrator of the U.S. Agency for International Development; Directors of the National Institutes of Health (NIH) and of the Centers for Disease Control and Prevention (CDC); and heads of other agencies designated by the President. The task force would have been required to hold a public meeting at least once each calendar year to receive views on relevant U.S. Government activities.

H.R. 2069 would also require the establishment of a Global Health Advisory Board to assist the President and other Federal officials in the administration and implementation of U.S. international health programs.

H.R. 2069 also would have required the establishment of a Global Health Advisory Board to assist the President and other Federal officials in the administration and implementation of U.S. international health programs.

S. 2649-The International AIDS Treatment and Prevention Act of 2002

Provisions of S. 2649 would:

• Authorized the Secretary of HHS to carry out HIV/AIDS care, treatment, capacity development, and other appropriate activities in countries with, or at risk for, severe HIV/AIDS epidemic, acting through the Director of CDC and the Administrator of the Health Resources and Services Administration (HRSA).
• Required the Secretary of HHS, acting through the Director of NIH and the Administrator of HRSA, to award supplemental grants to eligible entities (recipients of an NIH international HIV/AIDS clinical research, education, or training grant) and provide support for clinical education and training regarding the delivery of HIV/AIDS care and treatment services.
• Required the Secretary of HHS, acting through the Director of the U.S. Department of Health and Human Services Office of International Affairs, to ensure coordination of all Departmental programs related to prevention, treatment, and monitoring of HIV/AIDS in countries with or at risk for severe HIV/AIDS epidemic.

With respect to microbicides for preventing transmission of HIV and other sexually transmitted diseases, the Secretary of HHS would have been required to:

• Expand, intensify, and coordinate NIH research activities related to the development of microbicides, acting through the Director of the NIH Office of AIDS Research (OAR) and in coordination with other relevant institutes and offices.
• Expedite implementation of the microbicides research strategic plan, acting through the Director of OAR and in consultation with the Director of the National Institute of Allergy and Infectious Diseases.
• Award grants or contracts for the development of multidisciplinary teams to conduct research on innovative microbicide concepts.

As written, the microbicide provisions acknowledged that NIH has a strategic plan for microbicides research already in place. These provisions were also the result of increasing pressure from women's groups who feel that more attention needs to be paid to the development and testing of women-controlled barrier methods. The bill, however, sought to ensure a coordinated approach within and across agencies as it relates to the global HIV/AIDS epidemic.

Status and Outlook

H.R. 2069 was introduced on June 6, 2001, and was referred to the House International Relations Committee. During a Committee markup on June 27, the measure was amended and ordered to be reported. A report was filed on July 12 (H. Report 107-137). H.R. 2069 was considered in the House on December 11 and passed by a two-thirds majority vote.

S. 2649 was introduced on June 21, 2002, and was referred to the Senate Health, Education, Labor and Pensions Committee. On June 26, the Committee marked up S. 2649, in the nature of a substitute, and ordered the measure to be reported. Provisions specific to NIH programs were not significantly changed from the introduced bill. On July 12, provisions of S. 2649 and S. 2525, the United States Leadership Against HIV/AIDS, Tuberculosis, and Malaria Act of 2002, were offered as an amendment to H.R. 2069 and adopted. The amended H.R. 2069 was passed by the Senate and returned to the House on July 15. Conference action on the House- and Senate-passed versions of H.R. 2069 was not scheduled prior to the end of the 107th Congress.

For related information, see the articles entitled "Global Access to AIDS Treatment Act of 2001" and "Global HIV/AIDS, Tuberculosis, and Malaria."

For additional information on congressional interest in microbicides research, see the article entitled "Microbicide Development Act of 2001."