[113th Congress Public Law 56]
[From the U.S. Government Publishing Office]
[[Page 647]]
PEPFAR STEWARDSHIP AND OVERSIGHT ACT OF 2013
[[Page 127 STAT. 648]]
Public Law 113-56
113th Congress
An Act
To extend authorities related to global HIV/AIDS and to promote
oversight of United States programs. <<NOTE: Dec. 2, 2013 - [S.
1545]>>
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled, <<NOTE: PEPFAR
Stewardship and Oversight Act of 2013. 22 USC 7601 note.>>
SECTION 1. SHORT TITLE.
This Act may be cited as the ``PEPFAR Stewardship and Oversight Act
of 2013''.
SEC. 2. INSPECTOR GENERAL OVERSIGHT.
Section 101(f)(1) of the United States Leadership Against HIV/AIDS,
Tuberculosis, and Malaria Act of 2003 (22 U.S.C. 7611(f)(1)) is
amended--
(1) in subparagraph (A), by striking ``5 coordinated annual
plans for oversight activity in each of the fiscal years 2009
through 2013'' and inserting ``coordinated annual plans for
oversight activity in each of the fiscal years 2009 through
2018''; and
(2) in subparagraph (C)--
(A) <<NOTE: Deadlines.>> in clause (ii)--
(i) in the heading, by striking ``Subsequent''
and inserting ``2010 through 2013''; and
(ii) by striking ``the last four plans'' and
inserting ``the plans for fiscal years 2010
through 2013''; and
(B) by adding at the end the following new clause:
``(iii) 2014 plan.--The plan developed under
subparagraph (A) for fiscal year 2014 shall be
completed not later than 60 days after the date of
the enactment of the PEPFAR Stewardship and
Oversight Act of 2013.
``(iv) Subsequent plans.--Each of the last
four plans developed under subparagraph (A) shall
be completed not later than 30 days before each of
the fiscal years 2015 through 2018,
respectively.''.
SEC. 3. ANNUAL TREATMENT STUDY.
(a) Annual Study; Message.--Section 101(g) of the United States
Leadership Against HIV/AIDS, Tuberculosis, and Malaria Act of 2003 (22
U.S.C. 7611(g)) is amended--
(1) in paragraph (1), by striking ``through September 30,
2013'' and inserting ``through September 30, 2019'';
(2) by redesignating paragraph (2) as paragraph (3);
(3) by inserting after paragraph (1) the following new
paragraph:
[[Page 127 STAT. 649]]
``(2) 2013 through 2018 studies.--The studies required to be
submitted by September 30, 2014, and annually thereafter through
September 30, 2018, shall include, in addition to the elements
set forth under paragraph (1), the following elements:
``(A) A plan for conducting cost studies of United
States assistance under section 104A of the Foreign
Assistance Act of 1961 (22 U.S.C. 2151b-2) in partner
countries, taking into account the goal for more
systematic collection of data, as well as the demands of
such analysis on available human and fiscal resources.
``(B) A comprehensive and harmonized expenditure
analysis by partner country, including--
``(i) an analysis of Global Fund and national
partner spending and comparable data across United
States, Global Fund, and national partner
spending; or
``(ii) where providing such comparable data is
not currently practicable, an explanation of why
it is not currently practicable, and when it will
be practicable.''; and
(4) by adding at the end the following new paragraph:
``(4) Partner country defined.--In this subsection, the term
`partner country' means a country with a minimum United States
Government investment of HIV/AIDS assistance of at least
$5,000,000 in the prior fiscal year.''.
SEC. 4. PARTICIPATION IN THE GLOBAL FUND TO FIGHT AIDS,
TUBERCULOSIS, AND MALARIA.
(a) Limitation.--Section 202(d)(4) of the United States Leadership
Against HIV/AIDS, Tuberculosis, and Malaria Act of 2003 (22 U.S.C.
7622(d)(4)) is amended--
(1) in subparagraph (A)--
(A) in clause (i), by striking ``2013'' and
inserting ``2018'';
(B) in clause (ii)--
(i) by striking ``2013'' and inserting
``2018''; and
(ii) by striking the last two sentences; and
(C) in clause (vi), by striking ``2013'' and
inserting ``2018''; and
(2) in subparagraph (B)--
(A) by striking ``under this subsection'' each place
it appears;
(B) in clause (ii), by striking ``pursuant to the
authorization of appropriations under section 401'' and
inserting ``to carry out section 104A of the Foreign
Assistance Act of 1961''; and
(C) in clause (iv), by striking ``2013'' and
inserting ``2018''.
(b) Withholding Funds.--Section 202(d)(5) of the United States
Leadership Against HIV/AIDS, Tuberculosis, and Malaria Act of 2003 (22
U.S.C. 7622(d)) is amended by--
(1) in paragraph (5)--
(A) by striking ``2013'' and inserting ``2018'';
(B) in subparagraph (C)--
(i) by inserting ``in an open, machine
readable format'' after ``site'';
(ii) by amending clause (v) to read as
follows:
[[Page 127 STAT. 650]]
``(v) a regular collection, analysis, and
reporting of performance data and funding of
grants of the Global Fund, which covers all
principal recipients and all subrecipients on the
fiscal cycle of each grant, and includes the
distribution of resources, by grant and principal
recipient and subrecipient, for prevention, care,
treatment, drugs, and commodities purchase, and
other purposes as practicable;'';
(C) in subparagraph (D)(ii), by inserting ``, in an
open, machine readable format,'' after ``audits'';
(D) in subparagraph (E), by inserting ``, in an
open, machine readable format,'' after ``publicly'';
(E) in subparagraph (F)--
(i) in clause (i), by striking ``; and'' and
inserting a semicolon; and
(ii) by striking clause (ii) and inserting the
following new clauses:
``(ii) all principal recipients and
subrecipients and the amount of funds disbursed to
each principal recipient and subrecipient on the
fiscal cycle of the grant;
``(iii) expenditure data--
``(I) tracked by principal
recipients and subrecipients by program
area, where practicable, prevention,
care, and treatment and reported in a
format that allows comparison with other
funding streams in each country; or
``(II) if such expenditure data is
not available, outlay or disbursement
data, and an explanation of progress
made toward providing such expenditure
data; and
``(iv) high-quality grant performance
evaluations measuring inputs, outputs, and
outcomes, as appropriate, with the goal of
achieving outcome reporting;''; and
(F) by amending subparagraph (G) to read as follows:
``(G) <<NOTE: Web posting.>> has published an
annual report on a publicly available Web site in an
open, machine readable format, that includes--
``(i) a list of all countries imposing import
duties and internal taxes on any goods or services
financed by the Global Fund;
``(ii) a description of the types of goods or
services on which the import duties and internal
taxes are levied;
``(iii) the total cost of the import duties
and internal taxes;
``(iv) recovered import duties or internal
taxes; and
``(v) the status of country status-
agreements;''.
SEC. 5. ANNUAL REPORT.
Section 104A(f) of the Foreign Assistance Act of 1961 (22 U.S.C.
2151b-2(f)) is amended to read as follows:
``(f) Annual Report.--
``(1) <<NOTE: President.>> In general.--Not later than
February 15, 2014, and annually thereafter, the President shall
submit to the Committee on Foreign Relations of the Senate and
the Committee
[[Page 127 STAT. 651]]
on Foreign Affairs of the House of Representatives a report in
an open, machine readable format, on the implementation of this
section for the prior fiscal year.
``(2) Report due in 2014.--The report due not later than
February 15, 2014, shall include the elements required by law
prior to the enactment of the PEPFAR Stewardship and Oversight
Act of 2013.
``(3) Report elements.--Each report submitted after February
15, 2014, shall include the following:
``(A) A description based on internationally
available data, and where practicable high-quality
country-based data, of the total global burden and need
for HIV/AIDS prevention, treatment, and care,
including--
``(i) estimates by partner country of the
global burden and need; and
``(ii) HIV incidence, prevalence, and AIDS
deaths for the reporting period.
``(B) Reporting on annual targets across prevention,
treatment, and care interventions in partner countries,
including--
``(i) a description of how those targets are
designed to--
``(I) ensure that the annual
increase in new patients on
antiretroviral treatment exceeds the
number of annual new HIV infections;
``(II) reduce the number of new HIV
infections below the number of deaths
among persons infected with HIV; and
``(III) achieve an AIDS-free
generation;
``(ii) national targets across prevention,
treatment, and care that are--
``(I) established by partner
countries; or
``(II) where such national partner
country-developed targets are
unavailable, a description of progress
towards developing national partner
country targets; and
``(iii) bilateral programmatic targets across
prevention, treatment, and care, including--
``(I) the number of adults and
children to be directly supported on HIV
treatment under United States-funded
programs;
``(II) the number of adults and
children to be otherwise supported on
HIV treatment under United States-funded
programs; and
``(III) other programmatic targets
for activities directly and otherwise
supported by United States-funded
programs.
``(C) A description, by partner country, of HIV/AIDS
funding from all sources, including funding levels from
partner countries, other donors, and the private sector,
as practicable.
``(D) A description of how United States-funded
programs, in conjunction with the Global Fund, other
donors, and partner countries, together set targets,
measure progress, and achieve positive outcomes in
partner countries.
[[Page 127 STAT. 652]]
``(E) An annual assessment of outcome indicator
development, dissemination, and performance for programs
supported under this section, including ongoing
corrective actions to improve reporting.
``(F) A description and explanation of changes in
related guidance or policies related to implementation
of programs supported under this section.
``(G) An assessment and quantification of progress
over the reporting period toward achieving the targets
set forth in subparagraph (B), including--
``(i) the number, by partner country, of
persons on HIV treatment, including specifically--
``(I) the number of adults and
children on HIV treatment directly
supported by United States-funded
programs; and
``(II) the number of adults and
children on HIV treatment otherwise
supported by United States-funded
programs;
``(ii) HIV treatment coverage rates by partner
country;
``(iii) the net increase in persons on HIV
treatment by partner country;
``(iv) new infections of HIV by partner
country;
``(v) the number of HIV infections averted;
``(vi) antiretroviral treatment program
retention rates by partner country, including--
``(I) performance against annual
targets for program retention; and
``(II) the retention rate of persons
on HIV treatment directly supported by
United States-funded programs; and
``(vii) a description of supportive care.
``(H) A description of partner country and United
States-funded HIV/AIDS prevention programs and policies,
including--
``(i) an assessment by country of progress
towards targets set forth in subparagraph (B),
with a detailed description of the metrics used to
assess--
``(I) programs to prevent mother to
child transmission of HIV/AIDS,
including coverage rates;
``(II) programs to provide or
promote voluntary medical male
circumcision, including coverage rates;
``(III) programs for behavior-
change; and
``(IV) other programmatic activities
to prevent the transmission of HIV;
``(ii) antiretroviral treatment as prevention;
and
``(iii) a description of any new preventative
interventions or methodologies.
``(I) A description of the goals, scope, and
measurement of program efforts aimed at women and girls.
``(J) A description of the goals, scope, and
measurement of program efforts aimed at orphans,
vulnerable children, and youth.
``(K) A description of the indicators and milestones
used to assess effective, strategic, and appropriately
timed country ownership, including--
[[Page 127 STAT. 653]]
``(i) an explanation of the metrics used to
determine whether the pace of any transition to
such ownership is appropriate for that country,
given that country's level of readiness for such
transition;
``(ii) an analysis of governmental and local
nongovernmental capacity to sustain positive
outcomes;
``(iii) a description of measures taken to
improve partner country capacity to sustain
positive outcomes where needed; and
``(iv) for countries undergoing a transition
to greater country ownership, a description of
strategies to assess and mitigate programmatic and
financial risk and to ensure continued quality of
care for essential services.
``(L) A description, globally and by partner
country, of specific efforts to achieve and incentivize
greater programmatic and cost effectiveness, including--
``(i) progress toward establishing common
economic metrics across prevention, care and
treatment with partner countries and the Global
Fund;
``(ii) average costs, by country and by core
intervention;
``(iii) expenditure reporting in all program
areas, supplemented with targeted analyses of the
cost-effectiveness of specific interventions; and
``(iv) import duties and internal taxes
imposed on program commodities and services, by
country.
``(M) A description of partnership framework
agreements with countries, and regions where applicable,
including--
``(i) the objectives and structure of
partnership framework agreements with countries,
including--
``(I) how these agreements are
aligned with national HIV/AIDS plans and
public health strategies and commitments
of such countries; and
``(II) how these agreements
incorporate a role for civil society;
and
``(ii) a description of what has been learned
in advancing partnership framework agreements with
countries, and regions as applicable, in terms of
improved coordination and collaboration,
definition of clear roles and responsibilities of
participants and signers, and implications for how
to further strengthen these agreements with
mutually accountable measures of progress.
``(N) A description of efforts and activities to
engage new partners, including faith-based, locally-
based, and United States minority-serving institutions.
``(O) A definition and description of the
differentiation between directly and otherwise supported
activities, including specific efforts to clarify
programmatic attribution and contribution, as well as
timelines for dissemination and implementation.
``(P) A description, globally and by country, of
specific efforts to address co-infections and co-
morbidities of HIV/AIDS, including--
[[Page 127 STAT. 654]]
``(i) the number and percent of people in HIV
care or treatment who started tuberculosis
treatment; and
``(ii) the number and percentage of eligible
HIV positive patients starting isoniazid
preventative therapy.
``(Q) A description of efforts by partner countries
to train, employ, and retain health care workers,
including efforts to address workforce shortages.
``(R) A description of program evaluations completed
during the reporting period, including whether all
completed evaluations have been published on a
publically available Internet website and whether any
completed evaluations did not adhere to the common
evaluation standards of practice published under
paragraph (4).
``(4) <<NOTE: Web posting.>> Common evaluation standards.--
Not later than February 1, 2014, the Global AIDS Coordinator
shall publish on a publically available Internet website the
common evaluation standards of practice referred to in paragraph
(3)(R).
``(5) Partner country defined.--In this subsection, the term
`partner country' means a country with a minimum United States
Government investment of HIV/AIDS assistance of at least
$5,000,000 in the prior fiscal year.''.
SEC. 6. ALLOCATION OF FUNDING.
(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)''.
(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
[[Page 127 STAT. 655]]
out the provisions of section 104A of the Foreign Assistance Act
of 1961 (22 U.S.C. 2151b-2)''.
Approved December 2, 2013.
LEGISLATIVE HISTORY--S. 1545:
---------------------------------------------------------------------------
SENATE REPORTS: No. 113-112 (Comm. on Foreign Relations).
CONGRESSIONAL RECORD, Vol. 159 (2013):
Nov. 18, considered and passed Senate.
Nov. 19, considered and passed House.
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