Text of US HB 1880 (2011)

I 112TH CONGRESS 1ST SESSION H. R. 1880 To require, on the occasion of the 30th anniversary of the first reported cases of AIDS, reporting on the implementation of the National HIV/ AIDS Strategy and on the status of international progress towards achieving universal access to HIV/AIDS treatment, and for other pur- poses. IN THE HOUSE OF REPRESENTATIVES MAY 12, 2011 Ms. LEE of California (for herself, Mr. GRIJALVA, Mr. MORAN, Mr. CONYERS, Mr. MEEKS, Ms. NORTON, Mr. TOWNS, Mr. COURTNEY, Ms. SCHAKOWSKY, Mr. FRANK of Massachusetts, Ms. WILSON of Florida, Mr. COHEN, Ms. RICHARDSON, Mr. NADLER, Mrs. MALONEY, Mr. SERRANO, Mr. RANGEL, Mr. STARK, Ms. BORDALLO, Ms. BASS of California, Mr. ACKERMAN, Ms. BALDWIN, Mr. BECERRA, Ms. BERKLEY, Mr. BISHOP of Georgia, Mr. BRALEY of Iowa, Ms. BROWN of Florida, Mr. CICILLINE, Mr. CLARKE of Michigan, Ms. CLARKE of New York, Mr. CLAY, Mr. CLEAVER, Mr. CLYBURN, Ms. DEGETTE, Mr. CROWLEY, Mr. DAVIS of Illinois, Mrs. DAVIS of California, Ms. DELAURO, Mr. DOGGETT, Ms. ED- WARDS, Mr. ELLISON, Mr. FARR, Mr. FATTAH, Mr. GARAMENDI, Mr. GENE GREEN of Texas, Ms. HANABUSA, Mr. HASTINGS of Florida, Mr. HIGGINS, Mr. HOLDEN, Mr. HONDA, Ms. JACKSON LEE of Texas, Mr. LARSON of Connecticut, Ms. EDDIE BERNICE JOHNSON of Texas, Mr. JOHNSON of Georgia, Mr. LANGEVIN, Mr. LEVIN, Mr. MCNERNEY, Ms. MOORE, Mrs. NAPOLITANO, Mr. PASTOR of Arizona, Mr. PAYNE, Mr. PRICE of North Carolina, Mr. REYES, Mr. RICHMOND, Mr. RAHALL, Ms. ROYBAL-ALLARD, Mr. DAVID SCOTT of Georgia, Ms. SEWELL, Ms. SPEIER, Mr. THOMPSON of Mississippi, Mr. TONKO, Ms. TSONGAS, Mr. VAN HOLLEN, Ms. VELA´ZQUEZ, Ms. WASSERMAN SCHULTZ, Ms. WA- TERS, Mr. WATT, Mr. WAXMAN, Mr. WEINER, Ms. WOOLSEY, Mr. MCDERMOTT, Ms. PINGREE of Maine, Mr. DOYLE, Mr. TIERNEY, Mr. SCHIFF, Mr. OLVER, Mr. RUSH, and Mr. JACKSON of Illinois) introduced the following bill; which was referred to the Committee on Energy and Commerce, and in addition to the Committee on Foreign Affairs, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the com- mittee concerned VerDate Mar 15 2010 04:47 May 21, 2011 Jkt 099200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6652 E:\BILLS\H1880.IH H1880 tjames on DSKG8SOYB1PROD with BILLS 2 •HR 1880 IH A BILL To require, on the occasion of the 30th anniversary of the first reported cases of AIDS, reporting on the implemen- tation of the National HIV/AIDS Strategy and on the status of international progress towards achieving uni- versal access to HIV/AIDS treatment, and for other pur- poses. Be it enacted by the Senate and House of Representa- 1 tives of the United States of America in Congress assembled, 2 SECTION 1. SHORT TITLE. 3 This Act may be cited as the ‘‘Status Report on the 4 30th Anniversary of HIV/AIDS Act’’. 5 SEC. 2. FINDINGS. 6 The Congress makes the following findings: 7 (1) On June 5, 1981, in the Morbidity and 8 Mortality Weekly Report (MMWR), the Centers for 9 Disease Control and Prevention (CDC) reported the 10 identification of 5 cases of pneumocystis carinii 11 pneumonia (PCP), a rare type of pneumonia typi- 12 cally caused by a suppressed immune system. 13 (2) In 1982, public health officials began to use 14 the term ‘‘acquired immunodeficiency syndrome’’ or 15 AIDS, to describe the occurrence of opportunistic in- 16 fections among previously healthy people that were 17 subsequently associated with the initial 5 cases of 18 PCP identified in the MMWR. In 1983, scientists 19 VerDate Mar 15 2010 04:47 May 21, 2011 Jkt 099200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\H1880.IH H1880 tjames on DSKG8SOYB1PROD with BILLS 3 •HR 1880 IH isolated and identified the virus that causes AIDS, 1 which became known as human immunodeficiency 2 virus (HIV). 3 (3) HIV can be transmitted between persons 4 through unprotected sexual contact, including vag- 5 inal, anal, or oral sex, through contaminated injec- 6 tion needles or blood transfusions, and from a moth- 7 er to child during pregnancy or through breast milk. 8 HIV cannot be transmitted through saliva, tears, or 9 sweat, casual contact, mosquitoes or other insects, or 10 through the air or water. 11 (4) The Joint United Nations Programme on 12 HIV/AIDS (UNAIDS) estimates that since the iden- 13 tification of AIDS in 1981, more than 60,000,000 14 people have been infected with HIV, and nearly 15 30,000,000 people have died of AIDS worldwide. 16 (5) In 2009, 33,300,000 people were living with 17 HIV around the world, 1,800,000 people died of 18 AIDS-related illnesses, and another 2,600,000 peo- 19 ple were newly infected. Of these numbers, children 20 under the age of 15 accounted for 260,000 AIDS 21 deaths, 370,000 new HIV infections, and a total of 22 2,500,000 of all people living with HIV. 23 (6) Developing countries continue to bear the 24 brunt of the AIDS pandemic with sub-Saharan Afri- 25 VerDate Mar 15 2010 04:47 May 21, 2011 Jkt 099200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\H1880.IH H1880 tjames on DSKG8SOYB1PROD with BILLS 4 •HR 1880 IH ca accounting for 68 percent of all adults and chil- 1 dren living with HIV, 60 percent of whom are 2 women and girls. 3 (7) In 2008, the Tom Lantos and Henry J. 4 Hyde United States Global Leadership Against HIV/ 5 AIDS, Tuberculosis, and Malaria Reauthorization 6 Act was enacted into law, reauthorizing the Presi- 7 dent’s Emergency Plan for AIDS Relief (PEPFAR) 8 and continued United States participation and con- 9 tributions to the Global Fund to Fight AIDS, Tu- 10 berculosis and Malaria. 11 (8) Nearly 4.7 million people around the world 12 currently receive support for antiretroviral treatment 13 as a result of PEPFAR bilateral programs, the 14 Global Fund, or both. 15 (9) According to a recent report by the United 16 Nations Secretary-General, more than 6 million peo- 17 ple were estimated to be receiving antiretroviral 18 therapy in low- and middle-income countries as of 19 December 2010, while about 10 million people who 20 could benefit from treatment were not receiving it in 21 2009. 22 (10) In November 2010, UNAIDS and the 23 World Health Organization launched the concept of 24 ‘‘Treatment 2.0’’, a radically simplified HIV treat- 25 VerDate Mar 15 2010 04:47 May 21, 2011 Jkt 099200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\H1880.IH H1880 tjames on DSKG8SOYB1PROD with BILLS 5 •HR 1880 IH ment platform to achieve the goal of preventing 10 1 million deaths and reducing new HIV infections by 2 up to 1 million annually by optimizing drug regi- 3 mens, simplifying laboratory platforms for diagnosis 4 and monitoring, reducing costs, adapting delivery 5 systems, and mobilizing communities. 6 (11) The CDC estimates that in the United 7 States, more than 1,100,000 people are living with 8 HIV, and approximately 21 percent do not know 9 they are infected. 10 (12) Each year, 56,300 people become newly in- 11 fected with HIV in the United States, and on aver- 12 age, an individual is infected with HIV every 91⁄2 13 minutes. 14 (13) A total of 617,025 people have died of 15 AIDS in the United States from the beginning of 16 the HIV/AIDS epidemic through 2008. 17 (14) At the end of 2008, African-Americans 18 represented 48 percent of all people living with HIV 19 in the United States, Whites represented 33 percent, 20 Hispanics represented 17 percent, Asian-Americans 21 and Pacific Islanders represented 1 percent, and 22 American Indians and Alaska Natives represented 23 less than 1 percent. 24 VerDate Mar 15 2010 04:47 May 21, 2011 Jkt 099200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6201 E:\BILLS\H1880.IH H1880 tjames on DSKG8SOYB1PROD with BILLS 6 •HR 1880 IH (15) The leading transmission category of HIV 1 infection in the United States is male-to-male sexual 2 contact, followed by heterosexual contact and injec- 3 tion drug use. 4 (16) Men who have sex with men (MSM) of all 5 races remain the population most severely affected 6 by the disease, accounting for 54 percent of all new 7 HIV infections in 2008, with young MSM of color 8 representing an increasing share of new HIV infec- 9 tions over the past decade. African-American MSM 10 account for 35 percent of all new infections among 11 all MSM and 63 percent of all new infections among 12 African-American men, while Hispanic MSM ac- 13 count for 19 percent of all new infections among all 14 MSM and 72 percent of new infections among His- 15 panic men. 16 (17) Among women, the rate of new HIV infec- 17 tion for African-American women is nearly 15 times 18 higher than White women, while the rate among 19 Hispanic women is nearly 4 times higher. 20 (18) In 1998, Congress and the Clinton Admin- 21 istration created the National Minority AIDS Initia- 22 tive to provide technical assistance, build capacity, 23 and strengthen outreach efforts among local institu- 24 tions and community, based organizations that serve 25 VerDate Mar 15 2010 04:47 May 21, 2011 Jkt 099200 PO 00000 Frm 00006 Fmt 6652 Sfmt 6201 E:\BILLS\H1880.IH H1880 tjames on DSKG8SOYB1PROD with BILLS 7 •HR 1880 IH racial and ethnic minorities living with or vulnerable 1 to HIV/AIDS. 2 (19) In 2009, the Ryan White HIV/AIDS 3 Treatment Extension Act of 2009 was enacted into 4 law, reauthorizing Federal HIV/AIDS care and 5 treatment programs for 4 years and making funding 6 available to United States metropolitan areas, 7 States, and service providers to assist affected fami- 8 lies and persons living with HIV/AIDS with health 9 care and support services. 10 (20) As of April 7, 2011, approximately 7,900 11 people across 11 States were waiting to receive 12 AIDS treatment through the AIDS Drug Assistance 13 Program authorized by the Ryan White CARE Act. 14 (21) On July 13, 2010, the President released 15 a ‘‘National HIV/AIDS Strategy for the United 16 States’’ along with an accompanying ‘‘Federal Im- 17 plementation Plan’’ to achieve the goals of reducing 18 new HIV infections, increasing access to care and 19 improving health outcomes for people living with 20 HIV, reducing HIV-related disparities and health in- 21 equities, and achieving a more coordinated national 22 response to the HIV epidemic. 23 (22) In recognition of the 30th anniversary of 24 the first reported cases of AIDS, the United Nations 25 VerDate Mar 15 2010 04:47 May 21, 2011 Jkt 099200 PO 00000 Frm 00007 Fmt 6652 Sfmt 6201 E:\BILLS\H1880.IH H1880 tjames on DSKG8SOYB1PROD with BILLS 8 •HR 1880 IH General Assembly will hold a High Level Meeting on 1 AIDS from June 8–10, 2011, to consider a new 2 Declaration of Commitment on HIV/AIDS from 3 United Nations member states. 4 (23) The 19th International AIDS Conference 5 will be held in Washington, DC, from July 22–27, 6 2012, returning to the United States after a nearly 7 two decade long international boycott that was lifted 8 following the statutory repeal of a ban on travel and 9 immigration of people living with HIV/AIDS. 10 SEC. 3. REPORT ON THE IMPLEMENTATION OF THE NA- 11 TIONAL HIV/AIDS STRATEGY. 12 (a) REPORT REQUIRED.—Not later that 6 months 13 after the date of the enactment of this Act, the President, 14 in consultation with the heads of all relevant agencies in- 15 cluding the Department of Education, the Department of 16 Health and Human Services, the Department of Housing 17 and Urban Development, the Department of Justice, the 18 Department of Labor, the Department of Veterans Af- 19 fairs, and the Social Security Administration, shall trans- 20 mit to the Congress and make publicly available a report 21 on the status of the implementation of the National HIV/ 22 AIDS Strategy. 23 VerDate Mar 15 2010 04:47 May 21, 2011 Jkt 099200 PO 00000 Frm 00008 Fmt 6652 Sfmt 6201 E:\BILLS\H1880.IH H1880 tjames on DSKG8SOYB1PROD with BILLS 9 •HR 1880 IH (b) CONTENTS.—The report required by subsection 1 (a) shall include a description, analysis, and evaluation 2 of— 3 (1) key steps taken by the Federal Government 4 towards the achievement of the goals of the National 5 HIV/AIDS Strategy, including the goals of— 6 (A) reducing the number of people who be- 7 come infected with HIV; 8 (B) increasing access to care and opti- 9 mizing health outcomes for people living with 10 HIV; and 11 (C) reducing HIV-related health dispari- 12 ties; 13 (2) the extent to which the National HIV/AIDS 14 Strategy has improved coordination of efforts to 15 maximize the effective delivery of HIV/AIDS preven- 16 tion, care, and treatment services at the community 17 level, including coordination— 18 (A) within and among Federal agencies 19 and departments; 20 (B) between the Federal Government and 21 State and local governments and health depart- 22 ments; 23 (C) between the Federal Government and 24 nonprofit foundations and civil society organiza- 25 VerDate Mar 15 2010 04:47 May 21, 2011 Jkt 099200 PO 00000 Frm 00009 Fmt 6652 Sfmt 6201 E:\BILLS\H1880.IH H1880 tjames on DSKG8SOYB1PROD with BILLS 10 •HR 1880 IH tions, including community- and faith-based or- 1 ganizations focused on addressing the issue of 2 HIV/AIDS; and 3 (D) between the Federal Government and 4 private businesses. 5 (3) efforts by the Federal Government to edu- 6 cate, involve, and establish and strengthen partner- 7 ships with civil society organizations, including 8 community- and faith-based organizations, in order 9 to implement the National HIV/AIDS Strategy and 10 achieve its goals; 11 (4) how Federal resources are being deployed to 12 implement the Strategy, including— 13 (A) the amount of funding used to date, by 14 each Federal agency and department, to imple- 15 ment the National HIV/AIDS Strategy; 16 (B) a brief summary for each Federal 17 agency and department of the number and 18 function of all Federal employees assisting in 19 implementing the Strategy; and 20 (C) an estimate of the amount of funding 21 necessary to implement the National HIV/AIDS 22 Strategy, by each Federal agency and depart- 23 ment, for the next fiscal year; and 24 VerDate Mar 15 2010 04:47 May 21, 2011 Jkt 099200 PO 00000 Frm 00010 Fmt 6652 Sfmt 6201 E:\BILLS\H1880.IH H1880 tjames on DSKG8SOYB1PROD with BILLS 11 •HR 1880 IH (5) what additional steps, if any, are necessary 1 to fully implement the National HIV/AIDS Strategy, 2 including— 3 (A) whether any existing statutory laws, 4 policies, or regulations are impeding the imple- 5 mentation of the National HIV/AIDS Strategy, 6 at the Federal, State, or local level, and wheth- 7 er any changes to such laws, policies, or regula- 8 tions are necessary or recommended; and 9 (B) whether any Federal agencies or de- 10 partments require additional statutory authority 11 to effectively carry out their duties as part of 12 the National HIV/AIDS Strategy. 13 (c) USE OF PREVIOUSLY APPROPRIATED FUNDS.— 14 Funding for the report required under subsection (a) shall 15 derive from discretionary funds of the departments and 16 agencies specified in such subsection. 17 SEC. 4. REPORT ON PROGRESS TOWARDS ACHIEVING UNI- 18 VERSAL ACCESS TO HIV/AIDS TREATMENT. 19 (a) REPORT REQUIRED.—Not later than 6 months 20 after the date of the enactment of this Act, the President, 21 in consultation with the Global AIDS Coordinator and the 22 heads of all relevant agencies, including the Department 23 of State, the Department of Health and Human Services, 24 the United States Agency for International Development, 25 VerDate Mar 15 2010 04:47 May 21, 2011 Jkt 099200 PO 00000 Frm 00011 Fmt 6652 Sfmt 6201 E:\BILLS\H1880.IH H1880 tjames on DSKG8SOYB1PROD with BILLS 12 •HR 1880 IH the Centers for Disease Control and Prevention, and the 1 National Institutes of Health, shall transmit to the Con- 2 gress and make publicly available a report on the status 3 of international progress towards achieving universal ac- 4 cess to HIV/AIDS treatment for people living with HIV/ 5 AIDS. 6 (b) CONTENTS.—The report required by subsection 7 (a) shall include a description, analysis, and evaluation 8 of— 9 (1) the extent to which progress has been made 10 in achieving the goal of universal access to HIV/ 11 AIDS treatment on a country, regional, and global 12 basis, as well as addressing the ongoing challenges 13 and obstacles to achieving such goal, including— 14 (A) for the prevention of mother-to-child 15 transmission; 16 (B) with respect to the most-at-risk popu- 17 lations (MARPs) such as injection drug users, 18 sex workers and their clients, men who have sex 19 with men, transgender people, and prisoners; 20 (C) to ensure the availability of treatment 21 as prevention strategies; 22 (D) an estimate of the amount of funding 23 and resources provided to date in order to 24 VerDate Mar 15 2010 04:47 May 21, 2011 Jkt 099200 PO 00000 Frm 00012 Fmt 6652 Sfmt 6201 E:\BILLS\H1880.IH H1880 tjames on DSKG8SOYB1PROD with BILLS 13 •HR 1880 IH achieve the goal, including funding and re- 1 sources provided by— 2 (i) the United States; 3 (ii) partner countries; 4 (iii) the Global Fund to Fight AIDS, 5 Tuberculosis and Malaria, UNAIDS, the 6 World Health Organization, and other 7 multilateral institutions; 8 (iv) other donor nations; 9 (v) nonprofit foundations and civil-so- 10 ciety and nongovernmental organizations, 11 including community- and faith-based or- 12 ganizations; and 13 (vi) private businesses; and 14 (E) an estimate of the amount of funding 15 and resources still needed to accomplish the 16 goal; 17 (2) how the United States is contributing to the 18 achievement of the goal of universal access to HIV/ 19 AIDS treatment, including through— 20 (A) improved coordination and collabora- 21 tion among relevant Federal agencies and de- 22 partments and among— 23 (i) the United States; 24 (ii) partner countries; 25 VerDate Mar 15 2010 04:47 May 21, 2011 Jkt 099200 PO 00000 Frm 00013 Fmt 6652 Sfmt 6201 E:\BILLS\H1880.IH H1880 tjames on DSKG8SOYB1PROD with BILLS 14 •HR 1880 IH (iii) the Global Fund to Fight AIDS, 1 Tuberculosis and Malaria, UNAIDS, the 2 World Health Organization, and other 3 multilateral institutions; 4 (iv) other donor nations; 5 (v) nonprofit foundations and civil-so- 6 ciety and nongovernmental organizations, 7 including community- and faith-based or- 8 ganizations; and 9 (vi) private businesses; 10 (B) the identification and utilization of ef- 11 ficiencies in the delivery of HIV/AIDS treat- 12 ment services within and between United States 13 funded bilateral and multilateral programs, and 14 partner countries, including to the extent that 15 such gains in efficiencies are being exhausted; 16 (C) bilateral HIV/AIDS programs and 17 other bilateral global health programs; 18 (D) the Global Fund to Fight AIDS, Tu- 19 berculosis and Malaria; 20 (E) ongoing research into new, simpler, 21 more effective, and cheaper HIV treatment 22 regimens, including operational research to en- 23 sure that such treatments are adhered to and 24 delivered quickly and efficiently; 25 VerDate Mar 15 2010 04:47 May 21, 2011 Jkt 099200 PO 00000 Frm 00014 Fmt 6652 Sfmt 6201 E:\BILLS\H1880.IH H1880 tjames on DSKG8SOYB1PROD with BILLS 15 •HR 1880 IH (F) bilateral and multilateral efforts to 1 strengthen recruitment, training, and retention 2 of skilled indigenous health workers within na- 3 tional health systems of partner countries, in- 4 cluding to increase the effectiveness of such 5 health workers and ensure their equitable dis- 6 tribution within the country; 7 (G) bilateral and multilateral trade and in- 8 vestment negotiations, policies, or agreements, 9 especially in cases affecting the price, quality, 10 accessibility, and affordability of pharma- 11 ceuticals, including second-line pharmaceuticals, 12 diagnostics, and medical products and devices 13 (including any patents for or generic alter- 14 natives to such items) used to treat HIV/AIDS 15 and its associated opportunistic infections or 16 diseases; 17 (H) participation, contribution, and leader- 18 ship within multilateral institutions including 19 UNAIDS, the World Health Organization, the 20 United Nations, international financial institu- 21 tions, and other such multilateral institutions; 22 and 23 (I) the amount of funding and resources 24 provided by the United States to date, and an 25 VerDate Mar 15 2010 04:47 May 21, 2011 Jkt 099200 PO 00000 Frm 00015 Fmt 6652 Sfmt 6201 E:\BILLS\H1880.IH H1880 tjames on DSKG8SOYB1PROD with BILLS 16 •HR 1880 IH estimate of the amount of funding and re- 1 sources necessary for the next fiscal year; and 2 (3) the concept of ‘‘Treatment 2.0’’ as proposed 3 by UNAIDS and the World Health Organization to 4 improve and expand HIV treatment by optimizing 5 drug regimens, simplifying laboratory platforms for 6 diagnosis and monitoring, reducing costs, adapting 7 delivery systems, and mobilizing communities, in- 8 cluding— 9 (A) the progress achieved to date and any 10 challenges and obstacles to the realization of 11 the proposal; and 12 (B) a summary of efforts by the United 13 States in contributing to the realization of the 14 proposal, and any such planned actions by the 15 United States for the next fiscal year, includ- 16 ing— 17 (i) any proposed changes to United 18 States statutory laws, policies, or regula- 19 tions; and 20 (ii) the amount of funding and re- 21 sources provided to date by the United 22 States to support the proposal, and for the 23 next fiscal year. 24 VerDate Mar 15 2010 04:47 May 21, 2011 Jkt 099200 PO 00000 Frm 00016 Fmt 6652 Sfmt 6201 E:\BILLS\H1880.IH H1880 tjames on DSKG8SOYB1PROD with BILLS 17 •HR 1880 IH (c) USE OF PREVIOUSLY APPROPRIATED FUNDS.— 1 Funding for the report required under subsection (a) shall 2 derive from existing discretionary funds of the depart- 3 ments and agencies specified in such subsection. 4 SEC. 5. DEFINITIONS. 5 In this Act: 6 (1) HIV AND HIV/AIDS.—The terms ‘‘HIV’’ and 7 ‘‘HIV/AIDS’’ have the meanings given to such terms 8 in section 2689 of the Public Health Service Act (42 9 U.S.C. 300ff–88). 10 (2) INTERNATIONAL FINANCIAL INSTITU- 11 TION.—The term ‘‘international financial institu- 12 tion’’ means any of the following institutions: 13 (A) The International Bank for Recon- 14 struction and Development. 15 (B) The International Development Asso- 16 ciation. 17 (C) The International Finance Corpora- 18 tion. 19 (D) The Multilateral Investment Guar- 20 antee Agency. 21 (E) The International Centre for Settle- 22 ment of Investment Disputes. 23 (F) The Inter-American Development 24 Bank. 25 VerDate Mar 15 2010 04:47 May 21, 2011 Jkt 099200 PO 00000 Frm 00017 Fmt 6652 Sfmt 6201 E:\BILLS\H1880.IH H1880 tjames on DSKG8SOYB1PROD with BILLS 18 •HR 1880 IH (G) The Asian Development Bank. 1 (H) The Asian Development Fund. 2 (I) The African Development Bank. 3 (J) The African Development Fund. 4 (K) The International Monetary Fund. 5 (L) The North American Development 6 Bank. 7 (M) The European Bank for Reconstruc- 8 tion and Development. 9 (3) NATIONAL HIV/AIDS STRATEGY.—The term 10 ‘‘National HIV/AIDS Strategy’’ means the National 11 HIV/AIDS Strategy of the United States developed 12 by the President. 13 (4) TREATMENT AS PREVENTION.—The term 14 ‘‘treatment as prevention’’ means the strategy of 15 providing antiretroviral treatment to people living 16 with or vulnerable to HIV/AIDS in order to decrease 17 their risk of transmitting or becoming infected with 18 the virus. Such strategies may include— 19 (A) ‘‘pre-exposure prophylaxis’’ which 20 means the provision of antiretroviral drugs to 21 uninfected individuals before possible exposure 22 to the virus; and 23 (B) ‘‘test and treat’’ which means the test- 24 ing of everyone for HIV/AIDS within a high- 25 VerDate Mar 15 2010 04:47 May 21, 2011 Jkt 099200 PO 00000 Frm 00018 Fmt 6652 Sfmt 6201 E:\BILLS\H1880.IH H1880 tjames on DSKG8SOYB1PROD with BILLS 19 •HR 1880 IH risk group or a defined geographic area and the 1 immediate provision of antiretroviral treatment 2 to everyone who tests positive for the disease. 3 (5) UNAIDS.—The term ‘‘UNAIDS’’ means 4 the Joint United Nations Programme on HIV/AIDS. 5 Æ VerDate Mar 15 2010 04:47 May 21, 2011 Jkt 099200 PO 00000 Frm 00019 Fmt 6652 Sfmt 6301 E:\BILLS\H1880.IH H1880 tjames on DSKG8SOYB1PROD with BILLS