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107th CONGRESS
  1st Session
                                H. R. 684

   To authorize assistance for mother-to-child HIV/AIDS transmission 
                          prevention efforts.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                           February 14, 2001

    Ms. Millender-McDonald introduced the following bill; which was 
          referred to the Committee on International Relations

_______________________________________________________________________

                                 A BILL


 
   To authorize assistance for mother-to-child HIV/AIDS transmission 
                          prevention efforts.

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

SECTION 1. FINDINGS.

    Congress makes the following findings:
            (1) It is estimated that 10 percent of all individuals who 
        become infected with HIV/AIDS worldwide are children.
            (2) Mother-to-child transmission is the largest source of 
        HIV infection in children under age 15 and the only source for 
        very young children. The total number of births to HIV-infected 
        pregnant women each year in developing countries is 
        approximately 3,200,000.
            (3) In 1999, the United Nations estimated that 570,000 
        children age 14 or younger became infected with HIV. More than 
        90 percent were babies born to HIV-positive women. Almost \9/
        10\ of these babies were born in sub-Saharan Africa.
            (4) It is estimated that 1,800 infants become infected with 
        HIV each day worldwide.
            (5) HIV/AIDS has doubled infant mortality in the most 
        heavily impacted countries.
            (6) HIV may be transmitted during pregnancy, childbirth, 
        and breastfeeding. The risk of a baby acquiring HIV from an 
        infected mother ranges between 25-35 percent in developing 
        countries.

SEC. 2. STATEMENTS OF POLICY.

    Congress declares the following:
            (1) Primary prevention of mother-to-child transmission 
        through education and prophylaxis is important to protect women 
        of childbearing age from becoming infected with HIV in the 
        first place.
            (2) Counseling and voluntary testing are critical services 
        to help infected women accept their HIV status and the risk it 
        poses to their unborn child. Mothers who are aware of their 
        status can make informed decisions about sexual practices, 
        childbearing, and infant feeding.
            (3) Privacy is paramount in counseling and voluntary 
        services programs where women who are identified as HIV-
        positive may face discrimination, violence, and even death. 
        Measures must be undertaken that protect the pregnant woman's 
        absolute right to choose, on the basis of full information, 
        whether to take advantage of the intervention.
            (4) Based on an international study performed in Uganda in 
        1999, the drug nevirapine reduced mother-to-child transmission 
        of HIV/AIDS by 50 percent when given to the mother during labor 
        and delivery and when given as a single dose to the infant 
        within 72 hours of birth. This study constitutes a major 
        breakthrough in the fight against HIV/AIDS.
            (5) The cost of the combined mother and infant dose is 
        approximately $4, which makes a solution to this particular 
        mode of transmission practicable in the short to medium term.
            (6) Replacement feeding is an important part of the 
        strategy for lowering the rate of mother-to-child transmission 
        of HIV/AIDS but should not undermine decades of promoting 
        breastfeeding as the best possible nutrition for infants--which 
        has been effective in lowering infant mortality in developing 
        countries.
            (7) The affordability and cost-effectiveness of the 
        strategy are dependent upon the local health infrastructure and 
        cooperation with national and local policy decisionmakers and 
        health professionals.

SEC. 3. PILOT PROGRAMS FOR SUB-SAHARAN AFRICA AND INDIA TO PREVENT 
              MOTHER-TO-CHILD HIV/AIDS TRANSMISSION.

    (a) Establishment of Programs.--The Director of the Centers for 
Disease Control and Prevention shall, through the LIFE Initiative 
program, establish and carry out pilot programs for sub-Saharan Africa 
and India to prevent mother-to-child HIV/AIDS transmission through 
effective partnerships with nongovernmental organizations and 
university-based research facilities.
    (b) Conduct of Programs.--(1) The pilot programs shall be limited 
to prenatal voluntary counseling, voluntary testing, and use of 
nevarapine and replacement feeding to establish ``best practices'' 
locally before introducing the services more widely.
    (2) The pilot programs shall, at a minimum, consist of activities--
            (A) to address the issue of providers failing to recommend 
        and offer HIV testing to pregnant women;
            (B) to voluntarily test and provide counseling services 
        (with or without testing) that address the needs of pregnant 
        women are counseled regarding mother-to-child transmission of 
        HIV/AIDS;
            (C) to inform women who are infected of recommendations 
        about prophylactic treatment and assistance for those women who 
        elect to undergo treatment to be assisted to adhere to the 
        treatment regimen before, during, and after delivery;
            (D) to counsel women who undergo the treatment with their 
        infants and assistance to provide replacement feeding formula 
        in order to ensure that the women do not breastfeed their 
        babies; and
            (E) to provide treatment services that will be available 
        without regard to age, ancestry, color, disability, national 
        origin, race, religion, or political status.
    (c) Authorization of Appropriations.--
            (1) In general.--In addition to amounts otherwise available 
        for the purposes of this section, there are authorized to be 
        appropriated to carry out this section $5,000,000 for each of 
        the fiscal years 2002 through 2004.
            (2) Availability.--Amounts appropriated pursuant to the 
        authorization of appropriations under paragraph (1) are 
        authorized to remain available until expended.
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