HR 4914
110th CONGRESS
1st Session
H. R. 4914
To amend the United States Leadership Against HIV/AIDS, Tuberculosis,
and Malaria Act of 2003 to provide for the integration of food security
and nutrition activities into prevention, care, treatment, and support
activities.
IN THE HOUSE OF REPRESENTATIVES
December 19, 2007
Mr. PAYNE (for himself, Ms. WATSON, Ms. WOOLSEY, Ms. JACKSON-LEE of Texas,
and Mr. MILLER of North Carolina) introduced the following bill; which
was referred to the Committee on Foreign Affairs
A BILL
To amend the United States Leadership Against HIV/AIDS, Tuberculosis,
and Malaria Act of 2003 to provide for the integration of food security
and nutrition activities into prevention, care, treatment, and support
activities.
Be it enacted by the Senate and House of Representatives of the United
States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the `Global HIV/AIDS Food Security and Nutrition
Support Act of 2007'.
SEC. 2. FINDINGS.
Congress finds the following:
(1) The spread of HIV/AIDS is exacerbated by poverty, and economic and
social vulnerability, disempowerment, and inequality.
(2) Food insecurity has a direct detrimental impact on prevention, care,
and treatment of HIV/AIDS.
(3) Programming for HIV/AIDS must address the underlying factors that
contribute to the spread of the disease in order to be effective and
sustainable.
(4) The World Food Program estimates that 6,400,000 people affected
by HIV will need nutritional support by 2008.
(5) The highest rates of HIV infections are in countries with significant
rates of malnutrition, especially in sub-Saharan Africa.
(6) People living with HIV/AIDS are less productive due to illness,
which contributes to food insecurity for such individuals and their
households through loss of wages and/or decreased agricultural production.
(7) People caring for HIV-infected persons are often less productive
because of the demands of caring for those persons, which in turn can
lead to food insecurity for the infected person and the entire household.
(8) Adequate nutrition can extend the time that people infected with
HIV are able to work and be productive.
(9) Food insecurity is often cited by people living with HIV/AIDS as
their number one concern.
SEC. 3. SENSE OF CONGRESS.
It is the sense of Congress that--
(1) malnutrition, especially for people living with and affected by
HIV/AIDS, is a clinical health issue with wider nutrition, health, and
social implications for HIV-infected individuals, their families, and
communities that must be addressed by United States HIV/AIDS prevention,
care, treatment, and support programs;
(2) international guidelines established by the World Health Organization
should serve as the reference standard for HIV/AIDS food and nutrition
activities supported by the President's Emergency Plan for AIDS Relief
(PEPFAR);
(3) the Coordinator of United States Government Activities to Combat
HIV/AIDS Globally (commonly known as the `Global AIDS Coordinator')
should make it a priority to work with other United States Government
departments and agencies, donors, and multilateral institutions to increase
the integration of food and nutrition support and livelihood activities
into prevention, care, and treatment activities funded by the United
States and other governments and organizations;
(4) for the purposes of determining which HIV-infected individuals should
be provided with nutrition and food support, a patient with a body mass
index of 18.5 or less should be considered `malnourished' and should
be given priority for nutrition and food support;
(5) programs funded by the United States Government should include therapeutic
and supplementary feeding, food, and nutrition support and should include
strong links to development programs that focus on support for livelihoods;
and
(6) the inability of HIV-infected individuals to access food for themselves
or their families should not be allowed to impair or erode the therapeutic
status of such individuals with respect to HIV or related comorbidities.
SEC. 4. STATEMENT OF POLICY.
It is the policy of the United States to--
(1) address the food and nutrition needs of HIV-infected and affected
individuals, including orphans and vulnerable children;
(2) fully integrate food and nutrition support into care, treatment,
and support programs carried out under the United States Leadership
Against HIV/AIDS, Tuberculosis, and Malaria Act of 2003 (Public Law
108-25; 22 U.S.C. 7601 et seq.);
(A) care, treatment, and support providers and healthcare workers
are adequately trained such that they can provide accurate and informed
information regarding food and nutrition support to patients enrolled
in treatment and care programs and those affected by HIV; and
(B) HIV-infected individuals identified as food insecure, as well
as their households, are provided with adequate food and nutrition
support; and
(4) effectively link food and nutrition support to HIV-infected individuals
and their households and communities provided under Public Law 108-25
to other food security and livelihood programs funded by the United
States Government and other donors and multilateral agencies.
SEC. 5. INTEGRATION OF FOOD SECURITY AND NUTRITION ACTIVITIES INTO HIV/AIDS
PREVENTION, CARE, TREATMENT, AND SUPPORT ACTIVITIES.
Section 301 of the United States Leadership Against HIV/AIDS, Tuberculosis,
and Malaria Act of 2003 (Public Law 108-25; 22 U.S.C. 7631) is amended
by striking subsection (c) and inserting the following:
`(c) Integration of Food Security and Nutrition Activities Into Prevention,
Care, Treatment, and Support Activities-
`(1) STATEMENT OF POLICY- Congress declares that food security and nutrition
directly impact a patient's vulnerability to HIV infection, the progression
of HIV to AIDS, a patient's ability to begin an anti-retroviral medication
treatment regimen, the efficacy of an anti-retroviral medication treatment
regimen once a patient begins such a regimen, and the ability of communities
to effectively cope with the HIV/AIDS epidemic and its impacts.
`(2) REQUIREMENTS- Consistent with the statement of policy in paragraph
(1), the Global AIDS Coordinator shall--
`(i) an assessment, using validated criteria, of the food security
and nutritional status of each patient enrolled in anti-retroviral
medication treatment programs supported with funds authorized under
this Act or any amendment made by this Act is carried out; and
`(ii) appropriate nutritional counseling is provided to each patient
described in clause (i);
`(B) provide, as an essential component of anti-retroviral medication
treatment programs supported with funds authorized under this Act
or any amendment made by this Act, food and nutrition support to each
HIV-infected individual who is determined to need such support by
the assessing health professional, and the individual's household,
for a period of not less than 180 days, either directly or through
referral to an assistance program or organization with demonstrable
ability to provide such support;
`(C) coordinate with the Administrator of the United States Agency
for International Development, the Secretary of Agriculture, and heads
of other relevant United States Government departments and agencies
to--
`(i) ensure that, in communities in which a significant proportion
of HIV-infected individuals are in need of food and nutrition support,
a status and needs assessment for such support employing validated
criteria is conducted and a plan to provide such support is developed
and implemented;
`(ii) improve and enhance coordination between food security and
livelihood programs for HIV-infected individuals in focus countries
and food security and livelihood programs that may already exist
in those countries;
`(iii) establish effective linkages between the health and agricultural
development and livelihoods sectors in order to enhance food security;
and
`(iv) ensure, by providing increased resources if necessary, effective
coordination between activities authorized under this Act or any
amendment made by this Act and activities carried out under other
provisions of the Foreign Assistance Act of 1961 when establishing
new HIV/AIDS treatment sites;
`(D) develop effective, validated indicators which measure outcomes
of nutrition and food security interventions carried out under this
section and use such indicators to monitor and evaluate the effectiveness
of such interventions; and
`(E) support and expand partnerships and linkages between United States
colleges and universities with colleges and universities in focus
countries in order to provide training and build indigenous human
and institutional capacity and expertise to respond to HIV/AIDS, and
to improve capacity to address nutrition, food security and livelihood
needs of HIV/AIDS-affected and impoverished communities.
`(3) REPORT- Not later than 180 days after the date of the enactment
of the Global HIV/AIDS Food Security and Nutrition Support Act of 2007,
and annually thereafter, the Global AIDS Coordinator shall submit to
Congress a report on the implementation of this subsection for the prior
fiscal year. The report shall include a description of--
`(A) the indicators described in paragraph (2)(D) and a description
of the effectiveness of interventions carried out to improve the nutritional
status of HIV-infected individuals;
`(B) the amount of funds provided for food and nutrition support for
HIV-infected and affected individuals in the prior fiscal year and
the projected amount of funds to be provided for such purpose for
next fiscal year; and
`(C) a strategy for improving the linkage between assistance provided
with funds authorized under this subsection and food security and
livelihood programs under other provisions of law as well as activities
funded by other donors and multilateral organizations.
`(4) DEFINITIONS- In this subsection:
`(A) FOCUS COUNTRIES- The term `focus countries' means countries described
in section 1(f)(2)(B)(ii)(VII) of the State Department Basic Authorities
Act of 1956 (as added by section 102(a) of this Act) and designated
by the President pursuant to such section.
`(B) GLOBAL AIDS COORDINATOR- The term `Global AIDS Coordinator' means
the Coordinator of United States Government Activities to Combat HIV/AIDS
Globally (as described in section 1(f) of the State Department Basic
Authorities Act of 1956 (as added by section 102(a) of this Act)).
`(5) AUTHORIZATION OF APPROPRIATIONS- To carry out this subsection,
there are authorized to be appropriated to the Global AIDS Coordinator
such sums as may be necessary for each of the fiscal years 2009 through
2014.'
END
