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Title 22 — Foreign Relations and Intercourse

Chapter 83 — United States Leadership Against Hiv/aids, Tuberculosis, and Malaria

§ 7673. Allocation of funds

Statutory text

(a)

Balanced funding requirement

(1)

In general

The Global AIDS Coordinator shall—

(A)

provide balanced funding for prevention activities for sexual transmission of HIV/AIDS; and

(B)

ensure that activities promoting abstinence, delay of sexual debut, monogamy, fidelity, and partner reduction are implemented and funded in a meaningful and equitable way in the strategy for each host country based on objective epidemiological evidence as to the source of infections and in consultation with the government of each host county 1 involved in HIV/AIDS prevention activities.

(2)

Prevention strategy

(A)

Establishment

In carrying out paragraph (1), the Global AIDS Coordinator shall establish an HIV sexual transmission prevention strategy governing the expenditure of funds authorized under this chapter to prevent the sexual transmission of HIV in any host country with a generalized epidemic.

(B)

Report

In each host country described in subparagraph (A), if the strategy established under subparagraph (A) provides less than 50 percent of the funds described in subparagraph (A) for activities promoting abstinence, delay of sexual debut, monogamy, fidelity, and partner reduction, the Global AIDS Coordinator shall, not later than 30 days after the issuance of this strategy, report to the appropriate congressional committees on the justification for this decision.

(3)

Exclusion

Programs and activities that implement or purchase new prevention technologies or modalities, such as medical male circumcision, public education about risks to acquire HIV infection from blood exposures, promoting universal precautions, investigating suspected nosocomial infections, pre-exposure pharmaceutical prophylaxis to prevent transmission of HIV, or microbicides and programs and activities that provide counseling and testing for HIV or prevent mother-to-child prevention of HIV, shall not be included in determining compliance with paragraph (2).

(4)

Report

Not later than 1 year after , and annually thereafter as part of the annual report required under section 2151b–2(e) of this title, the President shall—

(A)

submit a report on the implementation of paragraph (2) for the most recently concluded fiscal year to the appropriate congressional committees; and

(B)

make the report described in subparagraph (A) available to the public.

(b)

Orphans and vulnerable children

For fiscal years 2009 through 2024 and fiscal year 2025 through March 25 of such fiscal year, not less than 10 percent of the amounts appropriated or otherwise made available to carry out the provisions of section 2151b–2 of this title for HIV/AIDS assistance for each such fiscal year shall be expended for assistance for orphans and other children affected by, or vulnerable to, HIV/AIDS, of which such amount at least 50 percent shall be provided through non-profit, nongovernmental organizations, including faith-based organizations, that implement programs on the community level.

(c)

Funding allocation

For each of the fiscal years 2009 through 2024 and for fiscal year 2025 through March 25 of such fiscal year, more than half of the amounts appropriated or otherwise made available to carry out the provisions of section 2151b–2 of this title shall be expended for—

(1)

antiretroviral treatment for HIV/AIDS;

(2)

clinical monitoring of HIV-seropositive people not in need of antiretroviral treatment;

(3)

care for associated opportunistic infections;

(4)

nutrition and food support for people living with HIV/AIDS; and

(5)

other essential HIV/AIDS-related medical care for people living with HIV/AIDS.

(d)

Treatment, prevention, and care goals

For each of the fiscal years 2009 through 2013—

(1)

the treatment goal under section 7672(a)(3) of this title shall be increased above 2,000,000 by at least the percentage increase in the amount appropriated for bilateral global HIV/AIDS assistance for such fiscal year compared with fiscal year 2008;

(2)

any increase in the treatment goal under section 7672(a)(3) of this title above the percentage increase in the amount appropriated for bilateral global HIV/AIDS assistance for such fiscal year compared with fiscal year 2008 shall be based on long-term requirements, epidemiological evidence, the share of treatment needs being met by partner governments and other sources of treatment funding, and other appropriate factors;

(3)

the treatment goal under section 7672(a)(3) of this title shall be increased above the number calculated under paragraph (1) by the same percentage that the average United States Government cost per patient of providing treatment in countries receiving bilateral HIV/AIDS assistance has decreased compared with fiscal year 2008; and

(4)

the prevention and care goals established in clauses (i) and (iv) of section 2151b–2(b)(1)(A) of this title shall be increased consistent with epidemiological evidence and available resources.

Footnotes

  1. 1 So in original. Probably should be “country”.

Legislative history

Reconstructed from this section’s Code source credit and amendment notes, resolved against the local Statutes at Large. Editorial notes are evidence, not the law that made the change.

  1. United States Leadership Against HIV/AIDS, Tuberculosis, and Malaria Act of 2003

    Pub. L. 108–25 title IV § 403 · 117 Stat. 711

    Enacted · 22 U.S.C. § 7673

    Pub. L. 108–25, title IV, § 403, May 27, 2003, 117 Stat. 746

    Source evidence

    Code source credit
    Pub. L. 108–25, title IV, § 403, May 27, 2003, 117 Stat. 746

    Enacted provision · exact public law section
    SEC. 403. ALLOCATION OF FUNDS. (a) Therapeutic Medical Care.— For fiscal years 2006 through 2008, not less than 55 percent of the amounts appropriated pursuant to the authorization of appropriations under section 401 for HIV/AIDS assistance for each such fiscal year shall be expended for therapeutic medical care of individuals infected with HIV, of which such amount at least 75 percent should be expended for the purchase and distribution of antiretroviral pharmaceuticals and at least 25 percent should be expended for related care. For fiscal years 2006 through 2008, not less than 33 percent of the amounts appropriated pursuant to the authorization of appropriations under section 401 for HIV/AIDS prevention consistent with section 104A(d) of the Foreign Assistance Act of 1961 (as added by section 301 of this Act) for each such fiscal year shall be expended for abstinence-until-marriage programs. (b) Orphans and Vulnerable Children.— For fiscal years 2006 through 2008, not less than 10 percent of the amounts appropriated pursuant to the authorization of appropriations under section 401 for HIV/AIDS assistance for each such fiscal year shall be expended for assistance for orphans and vulnerable children affected by HIV/AIDS, of which such amount at least 50 percent shall be provided through non-profit, nongovernmental organizations, including faith-based organizations, that implement programs on the community level.

  2. Tom Lantos and Henry J. Hyde United States Global Leadership Against HIV/AIDS, Tuberculosis, and Malaria Reauthorization Act of 2008

    Pub. L. 110–293 § 403(1) · 122 Stat. 2918

    Amended · 22 U.S.C. § 7673(a)

    Pub. L. 110–293, § 403(1), amended subsec. (a) generally. Prior to amendment, text read as follows: “For fiscal years 2006 through 2008, not less than 55 percent of the amounts appropriated pursuant to the authorization of appropriations under section 7671 of this title for HIV/AIDS assistance for each such fiscal year shall be expended for therapeutic medical care of individuals infected with HIV, of which such amount at least 75 percent should be expended for the purchase and distribution of antiretroviral pharmaceuticals and at least 25 percent should be expended for related care. For fiscal years 2006 through 2008, not less than 33 percent of the amounts appropriated pursuant to the authorization of appropriations under section 7671 of this title for HIV/AIDS prevention consistent with section 2151b–2(d) of this title for each such fiscal year shall be expended for abstinence-until-marriage programs.”

    Source evidence

    Code amendment note
    Subsec. (a). Pub. L. 110–293, § 403(1), amended subsec. (a) generally. Prior to amendment, text read as follows: “For fiscal years 2006 through 2008, not less than 55 percent of the amounts appropriated pursuant to the authorization of appropriations under section 7671 of this title for HIV/AIDS assistance for each such fiscal year shall be expended for therapeutic medical care of individuals infected with HIV, of which such amount at least 75 percent should be expended for the purchase and distribution of antiretroviral pharmaceuticals and at least 25 percent should be expended for related care. For fiscal years 2006 through 2008, not less than 33 percent of the amounts appropriated pursuant to the authorization of appropriations under section 7671 of this title for HIV/AIDS prevention consistent with section 2151b–2(d) of this title for each such fiscal year shall be expended for abstinence-until-marriage programs.”

    Enacted provision · exact public law section
    (1) by amending subsection (a) to read as follows: “(a) Balanced Funding Requirement.— “(1) In general.— The Global AIDS Coordinator shall— “(A) provide balanced funding for prevention activities for sexual transmission of HIV/AIDS; and “(B) ensure that activities promoting abstinence, delay of sexual debut, monogamy, fidelity, and partner reduction are implemented and funded in a meaningful and equitable way in the strategy for each host country based on objective epidemiological evidence as to the source of infections and in consultation with the government of each host county involved in HIV/AIDS prevention activities. “(2) Prevention strategy.— “(A) Establishment.— In carrying out paragraph (1), the Global AIDS Coordinator shall establish an HIV sexual transmission prevention strategy governing the expenditure of funds authorized under this Act to prevent the sexual transmission of HIV in any host country with a generalized epidemic. “(B) Report.— In each host country described in subparagraph (A), if the strategy established under subparagraph (A) provides less than 50 percent of the funds described in subparagraph (A) for activities promoting abstinence, delay of sexual debut, monogamy, fidelity, and partner reduction, the Global AIDS Coordinator shall, not later than 30 days after the issuance of this strategy, report to the appropriate congressional committees on the justification for this decision. “(3) Exclusion.— Programs and activities that implement or purchase new prevention technologies or modalities, such as medical male circumcision, public education about risks to acquire HIV infection from blood exposures, promoting universal precautions, investigating suspected nosocomial infections, pre-exposure pharmaceutical prophylaxis to prevent transmission of HIV, or microbicides and programs and activities that provide counseling and testing for HIV or prevent mother-to-child prevention of HIV, shall not be included in determining compliance with paragraph (2). “(4) Report.— Not President. later than 1 year after the date of the enactment of the Tom Lantos and Henry J. Hyde United States Global Leadership Against HIV/AIDS, Tuberculosis, and Malaria Reauthorization Act of 2008, and annually thereafter as part of the annual report required under section 104A(e) of the Foreign Assistance Act of 1961 (22 U.S.C. 2151b–2(e)), the President shall— “(A) submit a report on the implementation of paragraph (2) for the most recently concluded fiscal year to the appropriate congressional committees; and “(B) make the report described in subparagraph (A) available to the public.” ;

  3. Tom Lantos and Henry J. Hyde United States Global Leadership Against HIV/AIDS, Tuberculosis, and Malaria Reauthorization Act of 2008

    Pub. L. 110–293 § 403(2) · 122 Stat. 2918

    1. Substituted · 22 U.S.C. § 7673(b)

      Pub. L. 110–293, § 403(2), substituted “fiscal years 2009 through 2013” for “fiscal years 2006 through 2008”

    2. Substituted · 22 U.S.C. § 7673(b)

      Pub. L. 110–293, § 403(2), substituted “other children affected by, or vulnerable to,” for “vulnerable children affected by”

    Source evidence

    Code amendment note
    Subsec. (b). Pub. L. 110–293, § 403(2), substituted “fiscal years 2009 through 2013” for “fiscal years 2006 through 2008” and “other children affected by, or vulnerable to,” for “vulnerable children affected by”.

    Enacted provision · exact public law section
    (2) in subsection (b)— (A) by striking “fiscal years 2006 through 2008” and inserting “fiscal years 2009 through 2013”; and (B) by striking “vulnerable children affected by” and inserting “other children affected by, or vulnerable to,”; and

  4. Tom Lantos and Henry J. Hyde United States Global Leadership Against HIV/AIDS, Tuberculosis, and Malaria Reauthorization Act of 2008

    Pub. L. 110–293 § 403(3) · 122 Stat. 2918

    Added · 22 U.S.C. § 7673(c); 22 U.S.C. § 7673(d)

    Pub. L. 110–293, § 403(3), added subsecs. (c) and (d)

    Source evidence

    Code amendment note
    Subsecs. (c), (d). Pub. L. 110–293, § 403(3), added subsecs. (c) and (d).

    Enacted provision · exact public law section
    (3) by adding at the end the following: “(c) Funding Allocation.— For each of the fiscal years 2009 through 2013, more than half of the amounts appropriated for bilateral global HIV/AIDS assistance pursuant to section 401 shall be expended for— “(1) antiretroviral treatment for HIV/AIDS; “(2) clinical monitoring of HIV-seropositive people not in need of antiretroviral treatment; “(3) care for associated opportunistic infections; “(4) nutrition and food support for people living with HIV/AIDS; and “(5) other essential HIV/AIDS-related medical care for people living with HIV/AIDS. “(d) Treatment, Prevention, and Care Goals.— For each of the fiscal years 2009 through 2013— “(1) the treatment goal under section 402(a)(3) shall be increased above 2,000,000 by at least the percentage increase in the amount appropriated for bilateral global HIV/AIDS assistance for such fiscal year compared with fiscal year 2008; “(2) any increase in the treatment goal under section 402(a)(3) above the percentage increase in the amount appropriated for bilateral global HIV/AIDS assistance for such fiscal year compared with fiscal year 2008 shall be based on long- term requirements, epidemiological evidence, the share of treatment needs being met by partner governments and other sources of treatment funding, and other appropriate factors; “(3) the treatment goal under section 402(a)(3) shall be increased above the number calculated under paragraph (1) by the same percentage that the average United States Government cost per patient of providing treatment in countries receiving bilateral HIV/AIDS assistance has decreased compared with fiscal year 2008; and “(4) the prevention and care goals established in clauses (i) and (iv) of section 104A(b)(1)(A) of the Foreign Assistance Act of 1961 (22 U.S.C. 2151b–2(b)(1)(A)) shall be increased consistent with epidemiological evidence and available resources.” .

  5. PEPFAR Stewardship and Oversight Act of 2013

    Pub. L. 113–56 § 6(a) · 127 Stat. 648

    1. Substituted · 22 U.S.C. § 7673(b)

      Pub. L. 113–56, § 6(a), substituted “2018” for “2013”

    2. Substituted · 22 U.S.C. § 7673(b)

      Pub. L. 113–56, § 6(a), substituted “amounts appropriated or otherwise made available to carry out the provisions of section 2151b–2 of this title” for “amounts appropriated pursuant to the authorization of appropriations under section 7671 of this title”

    Source evidence

    Code amendment note
    Subsec. (b). Pub. L. 113–56, § 6(a), substituted “2018” for “2013” and “amounts appropriated or otherwise made available to carry out the provisions of section 2151b–2 of this title” for “amounts appropriated pursuant to the authorization of appropriations under section 7671 of this title”.

    Enacted provision · exact public law section
    (a) Orphans and Vulnerable Children.— Section 403(b) of the United States Leadership Against HIV/AIDS, Tuberculosis, and Malaria Act of 2003 (22 U.S.C. 7673(b)) is amended— (1) by striking “2013” and inserting “2018”; and (2) by striking “amounts appropriated pursuant to the authorization of appropriations under section 401” and inserting “amounts appropriated or otherwise made available to carry out the provisions of section 104A of the Foreign Assistance Act of 1961 (22 U.S.C. 2151b–2)”.

  6. PEPFAR Stewardship and Oversight Act of 2013

    Pub. L. 113–56 § 6(b) · 127 Stat. 648

    1. Substituted · 22 U.S.C. § 7673(c)

      Pub. L. 113–56, § 6(b), substituted “2018” for “2013” in introductory provisions

    2. Substituted · 22 U.S.C. § 7673(c)

      Pub. L. 113–56, § 6(b), substituted “amounts appropriated or otherwise made available to carry out the provisions of section 2151b–2 of this title” for “amounts appropriated for bilateral global HIV/AIDS assistance pursuant to section 7671 of this title” in introductory provisions

    Source evidence

    Code amendment note
    Subsec. (c). Pub. L. 113–56, § 6(b), substituted “2018” for “2013” and “amounts appropriated or otherwise made available to carry out the provisions of section 2151b–2 of this title” for “amounts appropriated for bilateral global HIV/AIDS assistance pursuant to section 7671 of this title” in introductory provisions.

    Enacted provision · exact public law section
    (b) Funding Allocation.— Section 403(c) of the United States Leadership Against HIV/AIDS, Tuberculosis, and Malaria Act of 2003 (22 U.S.C. 7673(c)) is amended— (1) by striking “2013” and inserting “2018”; and (2) by striking “amounts appropriated for bilateral global HIV/AIDS assistance pursuant to section 401” and inserting “amounts appropriated or otherwise made available to carry out the provisions of section 104A of the Foreign Assistance Act of 1961 (22 U.S.C. 2151b–2)”.

  7. PEPFAR Extension Act of 2018

    Pub. L. 115–305 § 4(1) · 132 Stat. 4402

    Substituted · 22 U.S.C. § 7673(b)

    Pub. L. 115–305, § 4(1), substituted “2023” for “2018”

    Source evidence

    Code amendment note
    Subsec. (b). Pub. L. 115–305, § 4(1), substituted “2023” for “2018”.

    Enacted provision · exact public law section
    (1) in subsection (b), by striking “2018” and inserting “2023”; and

  8. PEPFAR Extension Act of 2018

    Pub. L. 115–305 § 4(2) · 132 Stat. 4402

    Substituted · 22 U.S.C. § 7673(c)

    Pub. L. 115–305, § 4(2), substituted “2023” for “2018” in introductory provisions

    Source evidence

    Code amendment note
    Subsec. (c). Pub. L. 115–305, § 4(2), substituted “2023” for “2018” in introductory provisions.

    Enacted provision · exact public law section
    (2) in subsection (c), in the matter preceding paragraph (1), by striking “2018” and inserting “2023”.

  9. Pub. L. 118–47 § 7072(c)(1) · 138 Stat. 853

    Substituted · 22 U.S.C. § 7673(b)

    Pub. L. 118–47, § 7072(c)(1), substituted “2024 and fiscal year 2025 through March 25 of such fiscal year” for “2023”

    Unresolved: Pub. L. 118–47 was not found in the local Statutes at Large index.

    Source evidence

    Code amendment note
    Subsec. (b). Pub. L. 118–47, § 7072(c)(1), substituted “2024 and fiscal year 2025 through March 25 of such fiscal year” for “2023”.

  10. Pub. L. 118–47 § 7072(c)(2) · 138 Stat. 853

    Substituted · 22 U.S.C. § 7673(c)

    Pub. L. 118–47, § 7072(c)(2), substituted “2024 and for fiscal year 2025 through March 25 of such fiscal year” for “2023” in introductory provisions

    Unresolved: Pub. L. 118–47 was not found in the local Statutes at Large index.

    Source evidence

    Code amendment note
    Subsec. (c). Pub. L. 118–47, § 7072(c)(2), substituted “2024 and for fiscal year 2025 through March 25 of such fiscal year” for “2023” in introductory provisions.

11 of 13 references resolved to an enrolled provision · 2 unresolved

Editorial Notes

References in Text

This chapter, referred to in subsec. (a)(2)(A), was in the original “this Act”, meaning Pub. L. 108–25, , 117 Stat. 711, which is classified principally to this chapter. For complete classification of this Act to the Code, see Short Title note set out under section 7601 of this title and Tables.

Amendments2008–2024 · 4 rounds

2024

Subsec. (b). Pub. L. 118–47, § 7072(c)(1), substituted “2024 and fiscal year 2025 through March 25 of such fiscal year” for “2023”.

Subsec. (c). Pub. L. 118–47, § 7072(c)(2), substituted “2024 and for fiscal year 2025 through March 25 of such fiscal year” for “2023” in introductory provisions.

2018

Subsec. (b). Pub. L. 115–305, § 4(1), substituted “2023” for “2018”.

Subsec. (c). Pub. L. 115–305, § 4(2), substituted “2023” for “2018” in introductory provisions.

2013

Subsec. (b). Pub. L. 113–56, § 6(a), substituted “2018” for “2013” and “amounts appropriated or otherwise made available to carry out the provisions of section 2151b–2 of this title” for “amounts appropriated pursuant to the authorization of appropriations under section 7671 of this title”.

Subsec. (c). Pub. L. 113–56, § 6(b), substituted “2018” for “2013” and “amounts appropriated or otherwise made available to carry out the provisions of section 2151b–2 of this title” for “amounts appropriated for bilateral global HIV/AIDS assistance pursuant to section 7671 of this title” in introductory provisions.

2008

Subsec. (a). Pub. L. 110–293, § 403(1), amended subsec. (a) generally. Prior to amendment, text read as follows: “For fiscal years 2006 through 2008, not less than 55 percent of the amounts appropriated pursuant to the authorization of appropriations under section 7671 of this title for HIV/AIDS assistance for each such fiscal year shall be expended for therapeutic medical care of individuals infected with HIV, of which such amount at least 75 percent should be expended for the purchase and distribution of antiretroviral pharmaceuticals and at least 25 percent should be expended for related care. For fiscal years 2006 through 2008, not less than 33 percent of the amounts appropriated pursuant to the authorization of appropriations under section 7671 of this title for HIV/AIDS prevention consistent with section 2151b–2(d) of this title for each such fiscal year shall be expended for abstinence-until-marriage programs.”

Subsec. (b). Pub. L. 110–293, § 403(2), substituted “fiscal years 2009 through 2013” for “fiscal years 2006 through 2008” and “other children affected by, or vulnerable to,” for “vulnerable children affected by”.

Subsecs. (c), (d). Pub. L. 110–293, § 403(3), added subsecs. (c) and (d).

Credits

2003–2024 · 5 acts
  1. 2003Pub. L. 108–25, title IV, § 403, , 117 Stat. 746
  2. 2008Pub. L. 110–293, title IV, § 403, , 122 Stat. 2966
  3. 2013Pub. L. 113–56, § 6, , 127 Stat. 654
  4. 2018Pub. L. 115–305, § 4, , 132 Stat. 4403
  5. 2024Pub. L. 118–47, div. F, title VII, § 7072(c), , 138 Stat. 853.
Show as published

(Pub. L. 108–25, title IV, § 403, , 117 Stat. 746; Pub. L. 110–293, title IV, § 403, , 122 Stat. 2966; Pub. L. 113–56, § 6, , 127 Stat. 654; Pub. L. 115–305, § 4, , 132 Stat. 4403; Pub. L. 118–47, div. F, title VII, § 7072(c), , 138 Stat. 853.)

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