To provide assistance to combat infectious diseases in Haiti and to establish a comprehensive health infrastructure in Haiti, and for other purposes.

October 29, 2003

Ms. LEE (for herself, Mrs. CHRISTENSEN, Mr. WYNN, Mr. PAYNE, Mr. THOMPSON of Mississippi, Ms. JACKSON-LEE of Texas, Mr. CUMMINGS, Ms. MILLENDER-MCDONALD, Mr. WEXLER, Mr. CONYERS, Mr. OWENS, and Ms. CORRINE BROWN of Florida) introduced the following bill; which was referred to the Committee on International Relations

To provide assistance to combat infectious diseases in Haiti and to establish a comprehensive health infrastructure in Haiti, and for other purposes.

Be it enacted by the Senate and House of Representatives of the United States of America in Congress assembled,

SECTION 1. SHORT TITLE; TABLE OF CONTENTS.

(a) SHORT TITLE- This Act may be cited as the `New Partnership for Haiti Act of 2003'.

(b) TABLE OF CONTENTS- The table of contents of this Act is as follows:

Sec. 1. Short title; table of contents.

TITLE I--GENERAL PROVISIONS

Sec. 101. Findings.

Sec. 102. Purpose.

Sec. 103. Definitions.

Sec. 104. Development of a comprehensive strategy.

TITLE II--UNITED STATES ASSISTANCE FOR HAITI

Sec. 201. Assistance for health sector development.

Sec. 202. Assistance for health infrastructure development.

Sec. 203. Assistance for water and sanitation infrastructure development.

Sec. 204. Professional exchange for areas in Haiti severely affected by dilapidated physical health infrastructures.

TITLE I--GENERAL PROVISIONS

SEC. 101. FINDINGS.

Congress finds the following:

(1) Haiti is the most impoverished nation in the Western Hemisphere.

(2) The United Nations Joint Programme on HIV/AIDS states that Haiti accounts for 90 percent of the HIV/AIDS infections and case rates in the Caribbean.

(3) HIV infections and AIDS have approached epidemic proportions in Haiti. More than 300,000 infected people have been identified and deaths from HIV/AIDS have left approximately 200,000 children orphaned, while more than 12,000 children in Haiti are living with HIV/AIDS.

(4) The infant and maternal mortality rate in Haiti continues to rise and only 1 in every 10,000 Haitians has access to a physician.

(5) The Global Fund to Fight AIDS, Tuberculosis and Malaria has approved the control mechanisms of the Government of Haiti, which include measures to address transparency and for disbursement of grants from the Global Fund.

(6) The President has included Haiti in the list of 15 countries that qualify for United States assistance to combat HIV/AIDS under the United States Leadership Against HIV/AIDS, Tuberculosis, and Malaria Act of 2003.

(7) The people of Haiti have a constitutional and fundamental human right to health and government has the obligation to fulfill these rights to the level of resources available.

(8) The legal minimum daily wage in Haiti is approximately $.96 but many Haitians work in the informal economy or in subsistence agriculture for $.40 or less a day.

(9) 76 percent of Haiti's children under the age of five are underweight or suffer from wasting or stunting.

(10) Only 46 percent of the population has access to safe water and only 28 percent of the population to sanitation services.

(11) 63 percent of Haitians are undernourished. As stated by the United Nations Special Rapporteur on the Right to Food: `Despite the fact that global wealth and resources [are] sufficient to provide food for everyone, some 100,000 people [die] every day of hunger or hunger-related diseases [throughout the world].'.

(12) The infant mortality rate in Haiti is approximately 76 deaths for each 1,000 live female births and 81 deaths for each 1,000 live male births.

(13) Life expectancy at birth in Haiti is approximately 51 years.

(14) Approximately 80 percent of Haiti's population lives in abject poverty.

(15) Unemployment and underemployment is widespread in Haiti as evidenced by the fact that more than two-thirds of the labor force are without formal jobs.

(16)(A) The Office of Technical Assistance within the Bureau of International Affairs of the Department of the Treasury has provided advisers to governments in Central and Eastern Europe and the independent states of the former Soviet Union to assist in the transition from command to market economies.

(B) In the typical mission, a Treasury Department `resident advisor' provides assistance to a senior finance ministry or central bank counterpart in one of several areas: tax policy and administration, government debt issuance and management, financial institutions policy and regulation, budget policy and management, and the prevention, detection, and prosecution of financial crimes. These resident advisers are supported by short-term experts and technicians.

(17) More recently, the Department of the Treasury has addressed challenges in other parts of the world by assisting the South African Department of Finance in restructuring its budget office and process, working in the Haitian Finance Ministry to improve apportionment and budget execution, and helping to resolve the banking crisis in Indonesia.

SEC. 102. PURPOSE.

The purpose of this Act is to strengthen United States leadership and the effectiveness of the United States response to infectious diseases in Haiti and Haiti's

struggling health sector while assisting with the rebuilding of physical infrastructure by--

(1) establishing a comprehensive, integrated strategy to develop Haiti's health infrastructure, combat HIV/AIDS and other infectious diseases, and improve coordination among relevant Federal departments and agencies and between the United States and the Government of Haiti, nongovernmental organizations, and other international organizations;

(2) providing increased resources for United States efforts, particularly for technical assistance and training, to combat HIV/AIDS, tuberculosis, and malaria in Haiti;

(3) encouraging the expansion of the international community to reengage with the Government of Haiti and expand private sector efforts and public-private sector partnerships to establish a functional health sector in Haiti;

(4) assisting and securing a system of basic water, sanitation, and other physical infrastructure; and

(5) encouraging a continued exchange of knowledge and professionalism between the Government of Haiti and the United States Department of the Treasury through the Department's Office of Technical Assistance within the Bureau of International Affairs, including by providing Department of the Treasury advisers to work to explain such concepts as budgeting and the decision making process, tax policy as a means of financing the annual government budget, treasury bill markets to replace central bank monetization of deficits, and the banking as a system of intermediation rather than financial accounting.

SEC. 103. DEFINITIONS.

In this Act:

(1) AIDS- The term `AIDS' means the acquired immune deficiency syndrome.

(2) APPROPRIATE CONGRESSIONAL COMMITTEES- The term `appropriate congressional committees' means the Committee on International Relations of the House of Representatives and the Committee on Foreign Relations of the Senate.

(3) HIV- The term `HIV' means the human immunodeficiency virus, the pathogen that causes AIDS.

(4) HIV/AIDS- The term `HIV/AIDS' means, with respect to an individual, an individual who is infected with HIV or living with AIDS.

SEC. 104. DEVELOPMENT OF A COMPREHENSIVE STRATEGY.

The President shall seek to work with the Government of Haiti, the international financial community, civil society, and other international organizations to establish a comprehensive and integrated strategy to combat infectious diseases in Haiti and to establish a comprehensive health infrastructure in Haiti.

TITLE II--UNITED STATES ASSISTANCE FOR HAITI

SEC. 201. ASSISTANCE FOR HEALTH SECTOR DEVELOPMENT.

(a) STATEMENT OF POLICY- It is the policy of the United States--

(1) to assist in empowering the people of Haiti, particularly, women, young people and children, socially, economically, and intellectually to seek health as a human right and to prevent the transmission and contraction of HIV/AIDS, tuberculosis, malaria, and other infectious and endemic diseases; and

(2) to ensure that affordable effective health technologies, preventatives, and curatives are widely available to the people of Haiti.

(b) ASSISTANCE-

(1) IN GENERAL- The President, acting through the Administrator of the United States Agency for International Development, the Director of the Centers for Disease Control and Prevention, and the heads of other appropriate Federal departments and agencies, is authorized to provide assistance, on such terms and conditions as the President may determine, to facilitate the development of the health sector of Haiti.

(2) ACTIVITIES SUPPORTED- Assistance provided under paragraph (1) shall, to the maximum extent practicable, be used to carry out the following activities:

(A) Develop and expand the health sector in Haiti by expanding the current health infrastructure, targeting resources toward sanitation and water improvements, and developing best practices to fight serious health conditions in the country, including HIV/AIDS, tuberculosis, and malaria.

(B) Education, prevention, care, treatment, support, capacity development, and other activities relating to the prevention, treatment, and control of infectious diseases.

(c) AUTHORIZATION OF APPROPRIATIONS-

(1) IN GENERAL- There are authorized to be appropriated to carry out this section such sums as may be necessary for each of the fiscal years 2004 and 2005.

(2) AVAILABILITY- Amounts appropriated pursuant to the authorization of appropriations under paragraph (1) are authorized to remain available until expended.

SEC. 202. ASSISTANCE FOR HEALTH INFRASTRUCTURE DEVELOPMENT.

(a) ASSISTANCE-

(1) IN GENERAL- The President, acting through the Secretary of State and the United States Army Corps of Engineers, is authorized to provide assistance, on such terms and conditions as the President may determine, to facilitate the development of the basic sanitation and transportation infrastructure of Haiti.

(2) ACTIVITIES SUPPORTED- Assistance provided under paragraph (1) shall, to the maximum extent practicable, be used to carry out the following activities:

(A) Expand and further develop transportation and infrastructure projects in Haiti, including paving of roads and the availability of a health care vehicle or establishment of an emergency transportation plan in townships or

villages located more than 30 to 40 miles away from a health clinic.

(B) Commission an environmental impact study focused on the cost of development and paving of primary `dirt roads' located up to 30-40 miles away from major health clinics and provide the basic resources for the development and paving of such roads.

(b) REPORT- The President shall prepare and transmit to the appropriate congressional committees a report that contains the results of the environmental impact study carried out pursuant to subsection (a)(2)(B), including a cost analysis of carrying out the activities described in such subsection.

(c) AUTHORIZATION OF APPROPRIATIONS-

(1) IN GENERAL- There are authorized to be appropriated to carry out this section such sums as may be necessary for each of the fiscal years 2004 and 2005.

(2) AVAILABILITY- Amounts appropriated pursuant to the authorization of appropriations under paragraph (1) are authorized to remain available until expended.

SEC. 203. ASSISTANCE FOR WATER AND SANITATION INFRASTRUCTURE DEVELOPMENT.

(a) ASSISTANCE-

(1) IN GENERAL- The President, acting through the Secretary of State and the United States Army Corps of Engineers, is authorized to provide assistance, on such terms and conditions as the President may determine, to facilitate the development of the water and sanitation infrastructure of Haiti.

(2) ACTIVITIES SUPPORTED- Assistance provided under paragraph (1) shall, to the maximum extent practicable, be used to carry out the following activities:

(A) Expand and further develop water and sanitation infrastructure projects in Haiti, including assistance for development of sanitation and trash removal services in urban and rural areas of Haiti, development of sewage systems in areas with populations of at least 100,000 people, assistance and educational resources to improve water quality and delivery, and implementation of community water reserves to be maintained by public-private partnerships.

(B) Commission an environmental impact study focused on the effects of the deteriorating water and sanitation conditions in Haiti and provide the necessary resources for the improvement of such conditions.

(b) REPORT- The President shall prepare and transmit to the appropriate congressional committees a report that contains the results of the environmental impact study carried out pursuant to subsection (a)(2)(B), including a cost analysis of carrying out the activities described in such subsection and subparagraphs (C) and (D) of subsection (a)(2).

(c) AUTHORIZATION OF APPROPRIATIONS-

(1) IN GENERAL- There are authorized to be appropriated to carry out this section such sums as may be necessary for each of the fiscal years 2004 and 2005.

(2) AVAILABILITY- Amounts appropriated pursuant to the authorization of appropriations under paragraph (1) are authorized to remain available until expended.

SEC. 204. PROFESSIONAL EXCHANGE FOR AREAS IN HAITI SEVERELY AFFECTED BY DILAPIDATED PHYSICAL HEALTH INFRASTRUCTURES.

(a) IN GENERAL- The President shall establish a program to demonstrate the feasibility of facilitating the service of United States health care professionals and engineers in Haiti and its localities severely affected by dilapidated physical and health infrastructure, including but not limited to development of health clinics and health care, roads and sanitation development, and reconstruction of public facilities such as schools, hospitals, and clinics.

(b) REQUIREMENTS- Participants in the program shall provide basic services through training and participation, enter into partnerships with nongovernmental organizations and the United States Army Corp of Engineers, facilitate on-the-job training for residents of the area, and serve for a period of up to 3 years.

(c) ELIGIBILITY REQUIREMENTS- Candidates shall be residents of the Unites States who are trained professional in their respective field who meets licensure requirements necessary to be such a professional, including but not limited to physicians, nurses, nurse practictioners, pharmacists, and other types of health care professionals, engineers, architects, and any other individual determined to be appropriate by the President.

(d) RECRUITMENT- The President shall ensure that information on the program is widely distributed, including the distribution of information to schools and universities where professionals attain certification, hospitals, clinics, nongovernmental organizations working in the areas of international health and development, and any other location the President deems fit.

(e) COORDINATION- Placement of participants in the program shall be coordinated with the United States Agency for International Development in countries in which the Agency is conducting such programs. Overall placement of participants in the program shall be made by the President or his designee.

(f) INCENTIVES- The President may offer such incentives as the President determines to be necessary to encourage individuals to participate in the program, such as partial payment of principal, interest, and related expenses on government and commercials loans for educational expenses relating to professional training in their respective fields, and where possible, deferment of repayments on such loans, the provision of retirement benefits that would otherwise jeopardize participation in the program, and other incentives.

(g) REPORT- Not later than 18 months after the date of enactment of the Act, the President shall transmit to the appropriate congressional committees a report on steps taken to establish the program, including--

(1) the process of recruitment, including the venues for recruitment, the number of candidates recruited, the incentives offered, if any, and the cost of those incentives;

(2) the process, including the criteria used, for the selection of participants;

(3) the number of participants placed, the locality in which they were placed, and why those professionals were selected for that particular region of Haiti; and

(4) the potential for expansion of the program.

(h) AUTHORIZATION OF APPROPRIATIONS-

(1) IN GENERAL- There are authorized to be appropriated to carry out this section such sums as may be necessary for each of the fiscal years 2004 and 2005.

(2) AVAILABILITY- Amounts appropriated pursuant to the authorization of appropriations under paragraph (1) are authorized to remain available until expended.

END