[113th Congress Public Law 56]
[From the U.S. Government Printing 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.

                                  <all>