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108th Congress                                                   Report
                        HOUSE OF REPRESENTATIVES
 2d Session                                                     108-479
======================================================================
 
  ASSISTANCE FOR ORPHANS AND OTHER VULNERABLE CHILDREN IN DEVELOPING 
                         COUNTRIES ACT OF 2004

                                _______
                                

  May 5, 2004.--Committed to the Committee of the Whole House on the 
              State of the Union and ordered to be printed

                                _______
                                

Mr. Hyde, from the Committee on International Relations, submitted the 
                               following

                              R E P O R T

                        [To accompany H.R. 4061]

      [Including cost estimate of the Congressional Budget Office]

    The Committee on International Relations, to whom was 
referred the bill (H.R. 4061) to amend the Foreign Assistance 
Act of 1961 to provide assistance for orphans and other 
vulnerable children in developing countries, having considered 
the same, reports favorably thereon without amendment and 
recommends that the bill do pass.

                           TABLE OF CONTENTS

                                                                   Page
Purpose and Summary..............................................     1
Background and Need for the Legislation..........................     2
Hearings.........................................................     7
Committee Consideration..........................................     8
Votes of the Committee...........................................     8
Committee Oversight Findings.....................................     8
New Budget Authority and Tax Expenditures........................     8
Congressional Budget Office Cost Estimate........................     8
Performance Goals and Objectives.................................    10
Constitutional Authority Statement...............................    10
Section-by-Section Analysis......................................    10
New Advisory Committees..........................................    17
Congressional Accountability Act.................................    17
Federal Mandates.................................................    17
Changes in Existing Law Made by the Bill, as Reported............    17

                          Purpose and Summary

    The purpose of ``The Assistance for Orphans and Other 
Vulnerable Children Act of 2004'' (H.R. 4061) is to authorize 
assistance for orphans and other vulnerable children in 
developing countries for the fiscal years 2005 and 2006, and to 
establish important reforms to promote accountability and 
effectiveness of such programs, as administered by the U.S. 
Agency for International Development (USAID).
    H.R. 4061 will establish a variety of important new 
authorities relating to the provision of assistance for orphans 
and other vulnerable children into a single new title V in 
chapter 2 of part I of the Foreign Assistance Act of 1961.

                Background and Need for the Legislation

    Congress has demonstrated its support for assistance for 
orphans and other vulnerable children, most recently through 
Public Law 108-25 (The United States Leadership Against HIV/
AIDS, Tuberculosis, and Malaria Act of 2003), and through 
annual appropriations laws that have historically provided 
specific appropriations for the provision of assistance to 
displaced children and orphans. H.R. 4061 takes into account 
the diverse needs of orphans and other vulnerable children, 
especially such children orphaned or affected by HIV/AIDS, and 
creates a new title V in chapter 2 of part I of the Foreign 
Assistance Act of 1961 to house such authorities.
    The Committee believes it is essential that the United 
States Government adopt a comprehensive approach for the 
provision of assistance to orphans and other vulnerable 
children in developing countries, and that such a comprehensive 
approach should ensure that important services, such as basic 
care, health services including treatment for those children 
with HIV/AIDS, mental health problems (or conditions) and 
related services for those children affected by HIV/AIDS, 
school food programs, increased educational opportunities and 
employment training and related services, and the protection 
and promotion of inheritance rights, are made more accessible. 
The Committee considers that treatment shall include medical 
treatment for children, including the provision of anti-
retroviral drugs.
    An estimated 110 million orphans and other vulnerable 
children now live throughout Sub-Saharan Africa, Asia, Latin 
America and the Caribbean. Every 14 seconds another child is 
orphaned by AIDS. The global orphans crisis is a profound 
humanitarian disaster that will be felt for decades to come.
    Many African children are now born into a world without 
hope. With parents dying at an alarming rate, grandparents and 
extended families with few resources are called upon to take in 
additional children to feed, shelter and clothe. Children for 
whom there are no families often wind up in the streets at the 
mercy of criminals, traffickers and others who exploit their 
vulnerability. Street children live precarious lives without 
food, shelter, education, or protection. Such children face a 
greater risk for malnutrition, illness, abuse and exploitation. 
Girls take responsibility for more household chores and are 
especially likely to drop out of school and take on 
responsibilities for the care of an ailing parent. Orphaned 
children are less likely to receive basic education, health 
care, or job skills. By 2010, one in every four children will 
face this grim future in Botswana, Malawi, Uganda, Zambia, and 
Zimbabwe.
    School fees and related education costs also are often 
barriers to attending school. Despite national and 
international conventions that commit nations to provide free 
and compulsory education at the primary level, school fees 
continue to be levied in at least 100 countries. Other costs, 
such as books, school uniforms, transport or community 
contributions, are also common.
    The Committee believes that eliminating school fees is the 
single most effective step to ensuring universal access to 
education for orphans and other vulnerable children. In the 
poorest places in the world, school fees effectively keep 
millions of children out of school altogether. Eliminating 
school fees in some African countries has had an immediate and 
dramatic impact on expanding the number of children in school, 
and especially the opportunities for girls and AIDS orphans to 
go to school.
    Orphans rarely are able to attend school because many 
cannot afford school fees or are forced to financially support 
their families or care for sick relatives. Eliminating fees can 
also dramatically reduce the risk of girls contracting HIV, as 
evidence demonstrates a close link between schooling and 
reduced vulnerability to HIV. In addition, eliminating the need 
to find cash to pay school fees also reduces the severe 
pressure on mothers and other caretakers of children who may be 
forced in desperation to risk HIV infection by engaging in 
prostitution to raise money for school fees. The need to pay 
orphans' school fees is the biggest barrier to adoption of AIDS 
orphans. Removing school fees is necessary, but not sufficient 
to ensure increased attendance over the long term, and must 
also be coupled with action by developing countries and the 
international donor community to address the increased demand 
for additional teachers, classrooms, materials and financial 
resources.
    AIDS orphans are much more vulnerable to exploitation, 
including forced labor and physical and sexual abuse. Children 
without hope are more likely to be recruited, sometimes by 
force, by militias, rebel armies and terrorists. A 2001 Report 
by the International Crisis Group found that ``young people 
with no job, no income, and no family to support them are also 
at risk of joining, or being abducted by local militias.''
    The Committee finds that as a result of the numerous United 
States Government programs under which assistance is 
specifically authorized or otherwise available for orphans and 
vulnerable children in developing countries, the United States 
Agency for International Development will be required to 
develop innovative methods for the conduct and monitoring of 
these programs, including through the collection, analysis, and 
reporting of information on the programs. Innovative community-
based programs designed by indigenous communities are likely to 
develop the best approaches address the social, economic, and 
cultural needs of their children.
    The reforms of H.R. 4061 were prompted by recent Committee 
oversight of the Agency's implementation of Public Law 108-25, 
and of oversight of other programs relating to the provision of 
assistance for orphans and other vulnerable children.

                            THE LEGISLATION

    The ``Assistance for Orphans and Other Vulnerable Children 
in Developing Countries Act of 2004'' provides additional 
legislative authorities to the President with respect to the 
provision of assistance for orphans and other vulnerable 
children, and contains important provisions that will improve 
existing programs by increasing the Administration's oversight 
of and responsibility for dispersing funds and by creating 
better accountability while encouraging innovative initiatives 
within communities from the ground up.
    H.R. 4061 meets the concerns and implements the 
recommendations of the Committee and of the HIV/AIDS advocacy 
community by establishing responsibility for administration of 
programs for the assistance of orphans and other vulnerable 
children within a new Office of Orphans and Other Vulnerable 
Children, within the U.S. Agency for International Development.
    Currently, assistance programs for orphans and other 
vulnerable children are designed and managed primarily by the 
various field missions of the Agency. A small work unit within 
USAID's Bureau for Global Health (USAID/GH) provides technical 
assistance for assistance for children affected by HIV/AIDS, 
and other work units in the Agency have additional 
responsibilities for other aspects of assistance for orphans 
and vulnerable children, including other offices within USAID/
GH, and offices within the Bureau for Democracy, Conflict and 
Humanitarian Assistance (USAID/DCHA) and the Bureau for Africa 
(USAID/AFR).
    However, there is no office or individual within the Agency 
with responsibility for the overall oversight or implementation 
of programs for orphans and vulnerable children. H.R. 4061 
creates such an office, and provides it with responsibility and 
accountability to assure the intentions of Congress are met to 
promote effective community-based programming, document and 
disseminate information on best practices, and account more 
accurately for the expenditure of funds.
Providing Basic Care and Support
    The legislation expands the capacity of communities to take 
care of the basic needs of orphans. The bill also promotes 
school nutrition, psychosocial support and protection of the 
rights of orphans as key building blocks of a comprehensive 
response. As the number of child-headed households is growing 
rapidly, the need for extended families and community 
caregivers to play a greater role in the lives of these 
children is increasingly urgent.
    In communities across Africa, millions of people are 
volunteering their time and resources to care for orphans of 
AIDS and other vulnerable children. In addition to the care 
provided by families, in Malawi, Zambia, Uganda and many other 
countries, community volunteers identify and enumerate orphans 
and vulnerable children, provide what they can from community 
resources, and seek outside support for the basic needs of 
these children. These volunteers are linked to a community-
supported multi-service AIDS community center.
    Expanding and supporting such community-based care is 
critical, because when whole communities are responsible for 
raising orphaned children, the children are cared for in a rich 
and nurturing environment and remain connected to community 
traditions, rituals and family. Orphanages should be a last 
resort option because of their potential to separate orphans 
from the rest of the community without providing the 
psychosocial support mechanisms that are critical for healthy 
development.
School Feeding
    In sub-Saharan Africa alone, over 8 million additional 
children are underweight now as compared to a decade ago. 
Members of the family are often drawn away from production and 
other activities to care for the sick, compounding the problem 
of food insecurity and nutrition at the household level. 
Malnutrition enhances the risk that AIDS orphans and other 
vulnerable children will be at risk for infections, especially 
if they are infected with HIV. Today, it is estimated that 120 
million children around the world do not attend school, in part 
because of hunger and malnutrition, and the vast majority of 
these are young girls.
    School meals provide basic nutrition to children whose life 
circumstances do not necessarily offer reliable food supplies. 
Orphans have often seen one or both parents die slow deaths, 
impoverishing the household in an inevitably futile attempt to 
save parents' lives. The result is very often emotionally 
traumatized orphans with no financial resources. In particular, 
older children drop out of school to provide for younger ones, 
and girls often end up in sexually vulnerable situations in an 
effort to maintain reliable access to sufficient food. 
Providing meals at school would remove most orphans' single 
biggest daily worry, and reduce disease and stunting.
Expanding Educational Opportunity
    Eliminating school fees is essential to ensuring that 
millions of orphans and other poor and vulnerable children, 
especially girls, are enrolled in school. Orphans are often 
unable to attend school because many cannot afford school fees 
or are forced to financially support their families or care for 
sick relatives. Millions of girls from poor families do not 
attend school when families that cannot afford school costs 
send their sons to school instead of daughters. When countries 
in Africa have eliminated school fees, the resulting increases 
in enrollment have been dramatic. Kenya eliminated all fees for 
primary students in 2003 and school enrollment jumped by 22% 
within a few days of the policy change. In effect, over a 
million children gained access to education within a matter of 
weeks. In Uganda, debt relief funds were used to eliminate 
primary school fees 3 years ago and school enrollment increased 
by 40 percent.
    The experience of most countries that have eliminated 
school fees is that while there is a transition period where 
there is a major influx of new students and challenges to the 
existing education system, increased public and political 
attention on the schools following increased enrollment has 
helped catalyze resources to address scale-up and quality 
improvements.
    The Committee intends that, in addition to funds provided 
under this act to eliminate school fees especially in 
developing countries heavily affected by HIV/AIDS, the United 
States and the international donor community should also take 
into account the human and physical resources necessary to 
provide schooling of acceptable quality in the context of rapid 
expansion. Retention of children in school and increasing 
enrollment rates is strongly influenced by quality. The intent 
of this provision is ultimately to ensure that children who are 
currently excluded from school not only gain such access, but 
also stay in school through at least fifth grade to establish 
basic skills. It is also the intent of the Committee that 
efforts authorized under this provision complement ongoing 
efforts to increase school enrollment through basic education 
programs administered with United States bilateral assistance.
    Funds for this initiative should be provided in two or more 
tranches to countries. The first tranche should be provided 
when a country agrees to eliminate public primary school fees 
and reports increases in overall primary school enrollment 
rates and enrollment rates of girls compared to baseline 
enrollment levels and school completion rates. Subsequent 
tranches should be provided when it is confirmed that overall 
and girls' primary enrollments have increased compared to 
baseline levels and that the enrollment and completion rates of 
AIDS orphans and other affected children have increased 
compared to the baseline levels. Funds should be prioritized to 
support the transition costs of education for nations agreeing 
to eliminate public primary school fees and additionally 
promote best practices in education focused on the expansion of 
quality school enrollment.
    UNICEF is unusually well placed to lead this effort since 
it already finances school fees in many countries. The 
leadership of UNICEF has expressed enthusiasm for dramatically 
expanding its work around eliminating school fees. UNICEF will 
work with countries and coordinate other agencies and the key 
players within country. A UNICEF basic education incentive fund 
will leverage the elimination of fees and support the 
transitional costs to governments of eliminating fees and 
expanding enrollment.
Bringing the Hope of Treatment to Orphans
    As of 2003, 2.5 million children were living with HIV 
globally, and each year, an additional 700,000 babies are born 
infected with the virus, most through mother-to-child 
transmission. Many of these children will become orphans and 
without treatment, most will die by the age of two.
    With sustained drug treatment throughout childhood, the 
chances of long-term survival and a productive adulthood 
improve dramatically, bringing new hope to the littlest victims 
of AIDS. While the scientific evidence on the benefits of 
antiretroviral (ARV) treatment in children is clear, very few 
of these children have access to lifesaving AIDS medications 
and specialized care and treatment services. Most ARV programs 
do not prioritize treating children because medical and non-
medical staff are not adequately trained to treat them. 
Frequently this lack of training is compounded by a lack of 
proper dosing and safety information for existing drugs, which 
can be dramatically different for children as compared to 
adults, as well as the paucity of drugs specially formulated 
for children.
    Finally, an early and accurate diagnosis is also critical 
to providing optimal care for children. Currently, most 
programs cannot accurately diagnose infection in infants prior 
to 18 months of age because they lack the appropriate 
technology. While diagnostic tests exist that can detect the 
virus in younger children, they are expensive and are not 
available in most locations. Greater availability of this 
technology at a reduced cost could increase the chances of 
children receiving the most appropriate and timely care and 
ensure the most efficient use of scarce treatment resources.
    To fully level the playing field for orphans and vulnerable 
children, these issues must be prioritized within care and 
treatment programs so that children receive the same quality of 
care as adults.
Ensuring Accountability of Programs for Orphans
    The legislation builds in monitoring and evaluation 
criteria so that taxpayer money will be used in the most 
effective way to help orphans. The bill also provides improved 
coordination of orphans programs to ensure effective oversight 
of the response.
    By establishing an Office for Orphans and Vulnerable 
Children, the Agency will be better equipped to coordinate 
efforts within the Agency and among departments. Based on the 
successful implementation of the Displaced Children's and 
Orphans Fund (DCOF), this legislation creates a coordinated 
central organization that will review or approve all programs 
relating to orphans and other vulnerable children. This 
mechanism is urgently needed. Public Law 108-25 requires that 
by 2006, not less than 10 percent of HIV/AIDS funds be 
programmed for the needs of orphans and other children affected 
or made vulnerable by HIV/AIDS. Agencies will be held 
accountable for measurable results.
    The Committee intends that coordination within the Agency 
should include coordination with ongoing child survival 
programs, the Food for Peace Program, microenterprise 
development assistance programs, programs that provide 
assistance to civilians affected by conflict, and with ongoing 
efforts to improve basic education. In addition, the Office 
should coordinate with other departments and agencies, such as 
the Department of Treasury, which oversees programs for orphans 
and other vulnerable children of the World Bank, the Department 
of Agriculture which oversees the Dole-McGovern school feeding 
program and other food assistance efforts that are managed 
through the World Food Programme (WFP). Finally, the Office 
shall coordinate with Office of the Global AIDS Coordinator 
within the Department of State, which is primarily responsible 
for the oversight and coordination of all resources and 
international activities of the U.S. Government to combat HIV/
AIDS, as established by Public Law 108-25, the ``United States 
Leadership Against HIV/AIDS, Tuberculosis, and Malaria Act of 
2003.''
    By establishing a central monitoring and evaluation 
framework for programs to assist orphans and other vulnerable 
children, the Office will ensure sound investments are being 
made with taxpayer dollars. The Office should coordinate with 
other international agencies such as UNICEF and UNAIDS to 
ensure a global consensus exists on a common monitoring and 
evaluation framework. Ensuring that all USAID and United States 
Government entities are utilizing a common monitoring and 
evaluation framework for the provision of assistance for 
orphans and other vulnerable children is a key priority. The 
central monitoring and evaluation framework also will provide a 
mechanism for documenting and sharing best practices, create 
basis for targeted technical assistance to community-care 
centers and providers, and establish a sound basis for program 
revisions or policy changes directed by Congress.

                                Hearings

    The Committee did not hold any hearings specifically on 
assistance for orphans and vulnerable children during the 
second session of the 108th Congress prior to the consideration 
of H.R. 4061. However, on March 4, 2004, the Committee held an 
oversight hearing entitled ``The United States Government 
Strategy for Fighting HIV/AIDS: Implementation of Public Law 
108-25.'' Section 403(b) of Public Law 108-25 requires that for 
fiscal years 2006 through 2008, not less than 10 percent of 
amounts appropriated for HIV/AIDS assistance for each such 
fiscal year shall be expended for assistance for orphans and 
other vulnerable children affected by HIV/AIDS. During the 
107th Congress, the Committee held a hearing entitled ``AIDS 
Orphans and Vulnerable Children in Africa: Identifying the Best 
Practices for Care, Treatment, and Prevention'' on April 17, 
2002.

                        Committee Consideration

    The Committee considered H.R. 4061 at a meeting on March 
31, 2004.

                         Votes of the Committee

    There were no recorded votes during the consideration of 
H.R. 4061.

                      Committee Oversight Findings

    In compliance with clause 3(c)(1) of rule XIII of the Rules 
of the House of Representatives, the Committee reports that the 
findings and recommendations of the Committee, based on 
oversight activities under clause 2(b)(1) of rule X of the 
Rules of the House of Representatives, are incorporated in the 
descriptive portions of this report.

               New Budget Authority and Tax Expenditures

    Clause 3(c)(2) of House Rule XIII is inapplicable because 
this legislation does not provide new budgetary authority or 
increased tax expenditures.

               Congressional Budget Office Cost Estimate

                                     U.S. Congress,
                               Congressional Budget Office,
                                     Washington, DC, April 7, 2004.
Hon. Henry J. Hyde, Chairman,
Committee on International Relations,
House of Representatives, Washington, DC.
    Dear Mr. Chairman: The Congressional Budget Office has 
prepared the enclosed cost estimate for H.R. 4061, the 
Assistance for Orphans and Other Vulnerable Children in 
Developing Countries Act of 2004.
    If you wish further details on this estimate, we will be 
pleased to provide them. The CBO staff contact is Joseph C. 
Whitehill, who can be reached at 226-2840.
            Sincerely,
                                        Douglas Holtz-Eakin

Enclosure

cc:
        Honorable Tom Lantos,
        Ranking Member.
H.R. 4061--Assistance for Orphans and Other Vulnerable Childrenin 
        Developing Countries Act of 2004
    H.R. 4061 would establish within the U.S. Agency for 
International Development (USAID) a new Office for Orphans and 
Other Vulnerable Children. The office would be responsible for 
reviewing and approving all assistance provided by USAID to 
orphans and vulnerable children in developing countries and for 
coordinating all such assistance provided by other government 
agencies. The bill also would require the President to create a 
system for monitoring assistance to orphans and vulnerable 
children and to provide detailed reports to the Congress on 
such assistance. Based on information from USAID, CBO estimates 
that implementing H.R. 4061 would require an additional 15 
staff members and cost about $2 million each year, assuming the 
appropriation of the necessary funds. The bill would not affect 
direct spending or receipts.
    The United States provides hundreds of millions of dollars 
of assistance to children and their families in developing 
countries through bilateral assistance programs, such as the 
child survival and health programs fund; through contributions 
to international organizations, such as the United Nations 
Children's Fund (UNICEF); and through other assistance, such as 
the McGovern-Dole International Food for Education and Child 
Nutrition Program Grants. In addition, the United States 
Leadership Against HIV/AIDS, Tuberculosis, and Malaria Act of 
2003 requires that 10 percent of the $3 billion each year that 
is authorized by that act be spent for assistance to orphans 
and other children affected by HIV/AIDS.
    H.R. 4061 would provide specific authorization for 
assistance to orphans and vulnerable children: to provide basic 
care, to provide medical treatment and psychological support 
for children affected by HIV/AIDS, to provide school feeding 
programs, to increase educational opportunities and employment 
training, and to protect the inheritance rights of orphans. 
Those programs are currently being undertaken by USAID and 
other agencies under more general authority. The bill would not 
authorize the appropriation of additional funds for those 
programs; however, it would require centralized review and 
approval of all assistance to orphans and children undertaken 
by USAID and coordination of other agencies' assistance to 
children by the new office in USAID.
    Based on information from USAID, CBO estimates the new 
office would require a staff of between 30 to 45 personnel to 
review and approve all assistance for orphans and other 
vulnerable children, to create and maintain a monitoring 
system, and to prepare the required reports. We estimate that 
15 of those would be new positions and that it would cost an 
additional $2 million each year to operate the office, assuming 
the appropriation of the necessary funds.
    H.R. 4061 contains no intergovernmental or private-sector 
mandates as defined in the Unfunded Mandates Reform Act and 
would not affect the budgets of state, local, or tribal 
governments.

                    Performance Goals and Objectives

    The goals and objectives of this legislation are to improve 
the results and accountability of programs for the assistance 
of orphans and other vulnerable children, administered under 
the authority of the Foreign Assistance Act of 1961.

                   Constitutional Authority Statement

    Pursuant to clause 3(d)(1) of rule XIII of the Rules of the 
House of Representatives, the Committee finds the authority for 
this legislation in article I, section 8, clause 18 of the 
Constitution (relating to making all laws necessary and proper 
for carrying into execution powers vested by the Constitution 
in the Government of the United States).

               Section-by-Section Analysis and Discussion

    Section 1. Short Title. Section 1 contains a short title, 
the ``Assistance for Orphans and Other Vulnerable Children in 
Developing Countries Act of 2004.''
    Section 2. Findings and Declarations of Policy. Section 2 
contains 15 findings or statements of policy. The first 11 
paragraphs summarize data on infant and child morbidity and 
mortality; statistics of orphans in sub-Saharan Africa, Asia, 
Latin American and the Caribbean; and the characteristics of 
orphans and other vulnerable children with respect to 
nutrition, labor practices, and prevalence of disease, 
including HIV/AIDS. Paragraph 12 declares that a considerable 
number of United States and indigenous private voluntary 
organizations, including faith-based organizations, provide 
relatively modest amounts of assistance to orphans and other 
vulnerable children in developing countries, especially 
children affected by HIV/AIDS, and that while many of these 
organizations have submitted applications for grants from the 
United States Agency for International Development in order to 
provide increased levels of assistance for orphans and other 
vulnerable children in developing countries, in many cases the 
Agency has not approved applications. Paragraph 13 explains 
that Section 403(b) of the United States Leadership Against 
HIV/AIDS, Tuberculosis, and Malaria Act of 2003 (Public Law 
108-25) establishes the requirement that for fiscal years 2006 
through 2008, not less than 10 percent of amounts appropriated 
for HIV/AIDS assistance for each such fiscal year shall be 
expended for assistance for orphans and other vulnerable 
children affected by HIV/AIDS, and that 403(b) of Public Law 
108-25 requires that at least 50 percent of such amounts shall 
be provided through non-profit, nongovernmental organizations, 
including faith-based organizations, that implement programs on 
the community level. Paragraph 14 declares that it is essential 
that the United States Government adopt a comprehensive 
approach for the provision of assistance to orphans and other 
vulnerable children in developing countries, and that such a 
comprehensive approach should ensure that important services, 
such as basic care, treatment for those children with HIV/AIDS, 
mental health and related services for those children affected 
by HIV/AIDS, school food programs, increased educational 
opportunities and employment training and related services, and 
the protection and promotion of inheritance rights, are made 
more accessible. Paragraph 15 declares that as a result of the 
numerous United States Government programs under which 
assistance is specifically authorized or otherwise available 
for orphans and vulnerable children in developing countries, 
the United States Agency for International Development will be 
required to develop innovative methods for the conduct and 
monitoring of these programs, including through the collection, 
analysis, and reporting of information on the programs.
    Section 3. Assistance for Orphans and Other Vulnerable 
Children in Developing Countries. Section 3 amends title V of 
chapter 2 of part I of the Foreign Assistance Act of 1961 (22 
U.S.C. 2201) to read as follows: ``Title V--Assistance for 
Orphans and Other Vulnerable Children.'' The new title V has 12 
sections.
    Section 241, ``Findings; Declaration of Policy,'' is 
divided into two subsections.
    Section 241(a) includes six findings on the state of 
orphans and vulnerable children, including that by 2010, HIV/
AIDS will orphan more than 25,000,000 children worldwide; that 
ongoing conflicts and civil wars in developing countries are 
adversely affecting children in these countries, the vast 
majority of whom currently do not receive humanitarian 
assistance or other support from the United States Government; 
that although the United States Government currently 
administers assistance programs for orphans and other 
vulnerable children in developing countries, for fiscal year 
2002 the United States Agency for International Development 
reported that the United States Government provided assistance 
to only 462,000 such orphans and other vulnerable children, or 
less than \1/2\ of 1 percent of the estimated 108,000,000 total 
number of such orphans and other vulnerable children; that the 
United States Government should increase its efforts to provide 
assistance for orphans and other vulnerable children in 
developing countries, especially those children affected by 
HIV/AIDS or conflict; that the United States Agency for 
International Development should establish improved capacity to 
deliver assistance to orphans and other vulnerable children in 
developing countries through partnerships with private 
voluntary organizations, including faith-based organizations, 
and that the United States Agency for International Development 
should be the primary United States Government agency 
responsible for identifying and assisting orphans and other 
vulnerable children in developing countries.
    Section 241(b) includes a declaration of policy which 
states that Congress, recognizing that prompt and appropriate 
action by the United States to assist orphans and other 
vulnerable children in developing countries is an important 
expression of the humanitarian concern and tradition of the 
people of the United States, affirms the willingness of the 
United States to assist such orphans and other vulnerable 
children by providing assistance for the purpose of improving 
the health, nutritional, shelter, educational, economic, and 
psychological status of orphans and other vulnerable children 
in such countries; and by providing humanitarian and protection 
assistance to such orphans and other vulnerable children 
affected by conflict or civil strife.
    Section 242, ``Assistance to Provide Basic Care,'' is 
divided into two subsections.
    Section 242(a) includes three findings on the importance of 
mobilizing individuals and local organizations in developing 
countries to assist households headed by children is necessary 
due to the increase in the number of such households. Paragraph 
two states that when communities are responsible for raising 
orphans, such children are cared for in a rich and nurturing 
environment and remain connected to the traditions and rituals 
of families and the community. Paragraph three states that as 
the number of these children increases, the ability of 
communities to provide basic care for such children is limited. 
Assistance to support the provision of such basic care is 
therefore necessary in and of itself and also to facilitate the 
provision of other types of assistance for such children under 
this title.
    Section 242(b) authorizes the President to provide 
assistance for programs in developing countries to provide 
basic care for orphans and other vulnerable children. Such 
assistance should be used to support individuals and local 
organizations, including teachers, social workers, and 
representatives from religious institutions and nongovernmental 
organizations, to mobilize their own resources through the 
establishment of `community care councils' to provide basic 
care for orphans and other vulnerable children, including day 
care, food assistance, protection assistance, and home visits; 
to increase the capacity of community care councils to meet on 
a regular basis to identify orphans and other vulnerable 
children and to facilitate the provision of services; and to 
establish and operate centers in such communities to provide 
basic care.
    Section 243, ``Assistance to Provide Treatment to Orphans 
and Other Vulnerable Children with HIV/AIDS,'' is divided into 
two subsections.
    Section 243(a) includes six findings on the impact of HIV 
on children, including that approximately 2,500,000 children 
under the age of 15 worldwide have HIV/AIDS. Every day another 
2,000 children under the age of 15 are infected with HIV; that 
in 2002, approximately 2,500,000 children were at risk for 
infection with HIV through mother-to-child transmission, which 
includes transmission at any point during pregnancy, labor, 
delivery, or breastfeeding; that to date, more than 4,000,000 
children worldwide are estimated to have died from AIDS, 
primarily contracted through mother-to-child transmission; that 
every year, approximately 700,000 babies are infected with HIV, 
of which the majority are living in Africa; that in southern 
Africa HIV/AIDS is now the leading cause of death among young 
children, accounting for almost half of such deaths; that 
research has shown conclusively that initiation in a timely 
manner of antiretroviral therapy for infants or young children 
with HIV/AIDS can preserve or restore their immune functions, 
promote normal growth and development, and prolong life; and 
that few international development programs specifically target 
the treatment of children with HIV/AIDS in developing 
countries, due to the perceived low priority of pediatric 
treatment, a lack of pediatric health care professionals, lack 
of expertise and experience in pediatric drug dosing and 
monitoring, the perceived complexity of pediatric treatment, 
and mistaken beliefs regarding the risks and benefits of 
pediatric treatment.
    Section 243(b) authorizes the President to provide 
assistance for the treatment of orphans and other vulnerable 
children with HIV/AIDS in developing countries, and that such 
assistance should used for the provision of pharmaceuticals, 
including high-quality, low-cost antiretrovirals and other 
therapies, including generically manufactured pharmaceuticals 
where appropriate; and for the recruitment and training of 
individuals to provide the treatment, including the recruitment 
and training of appropriate support personnel.
    Section 244, ``Assistance to Provide Psychosocial Support 
to Orphans and Other Vulnerable Children Affected by HIV/
AIDS,'' is divided into two subsections.
    Section 244(a) includes five findings on the psychosocial 
problems of orphans and other vulnerable children affected by 
HIV/AIDS, including that many children who are orphaned as a 
result of AIDS blame themselves for the death of a parent and 
many children are separated from siblings, sometimes for life; 
that the trauma resulting from the loss of a parent as a result 
of AIDS can trigger behavior problems of aggression or 
emotional withdrawal and negatively affect a child's 
performance in school and the child's social relations; that 
children living in families affected by HIV/AIDS are often 
stigmatized, teased, and ostracized by peers; that children 
living in families affected by HIV/AIDS who are most vulnerable 
are those children in households headed by children; and that 
in many African countries, religious leaders are mobilizing 
individuals and local organizations within the community to 
identify and respond to the psychosocial needs of those 
children affected by AIDS.
    Section 244(b) authorizes the President to provide 
assistance for programs in developing countries to provide 
mental health treatment and related services to orphans and 
other vulnerable children affected by HIV/AIDS.
    Section 245 is divided into two subsections.
    Section 245(a) includes five findings on the relationship 
between HIV/AIDS, nutrition, and school attendance, including 
that in 2004, it is estimated that 125,000,000 children 
worldwide do not attend school, in part because of hunger and 
malnutrition, and the vast majority of these children are young 
girls; that school food programs, including take-home rations, 
in developing countries provide strong incentives for parents 
to send their children to school and ensure that they continue 
with their education. School food programs may reduce short-
term hunger, improve cognitive functions, and enhance learning, 
behavior, and achievement; that in 2004, more than 8,000,000 
children in sub-Saharan Africa are underweight compared to 
1994. Malnutrition enhances the risk that orphans and other 
vulnerable children will be at risk for illness and infections, 
especially if these children are also infected with HIV; that 
healthy members of families affected by HIV/AIDS in developing 
countries often leave the workforce to care for those family 
members with HIV/AIDS, which compounds the problem of access to 
food for the family; that although a number of organizations 
seek to meet the needs of children who are orphaned or 
vulnerable as a result of HIV/AIDS, local communities continue 
to be the primary providers of support for these children; and 
that according to a survey by the United States Agency for 
International Development, orphans and other vulnerable 
children relied on relatives for food support 74 percent of the 
time and on friends for food support 19 percent of the time.
    Section 245(b) authorizes the President to provide 
assistance for school food programs in developing countries, 
and that such assistance should be used to purchase local or 
regional foodstuffs, where appropriate, for school food 
programs.
    Section 246, ``Assistance to Increase Educational 
Opportunities and Provide Employment Training,'' is divided 
into two subsections.
    Section 246(a) includes six findings on the importance of 
nonformal education for orphans and other vulnerable children, 
including such children affected by HIV/AIDS, including that 
the lack of financial resources in families affected by HIV/
AIDS prevents many orphans and other vulnerable children in 
developing countries from attending school because of the 
requirement to pay school fees and other costs of education; 
that such children, in particular young girls, are often forced 
to miss school in order to serve as caregivers to relatives 
with HIV/AIDS or assume adult responsibilities for providing 
for the family. Younger children who lose a parent also lose 
the opportunity to learn skills that they will need to support 
themselves as they grow older; that according to the 
International Labor Organization, approximately 250,000,000 
children and adolescents ages 5 to 14 in developing countries 
are working part-time and approximately 120,000,000 children 
and adolescents ages 5 to 14 in developing countries are 
working full-time; that in many regions of Africa and other 
developing countries, non-formal education plays an important 
role to provide children who are unable to attend school with 
the employment and related life skills training such children 
need to survive; that many organizations in Africa, including 
faith-based organizations, provide employment and related life 
skills training for older children to better prepare them to 
serve as caregivers for younger siblings; and that 
organizations that provide non-formal education can assist the 
thousands of children in developing countries who are not 
currently being assisted by families or communities and are 
struggling to survive.
    Section 246(b) authorizes the President to provide 
assistance for programs in developing countries to increase 
enrollment in public primary schools by eliminating school fees 
and other costs of education, especially in developing 
countries heavily affected by HIV/AIDS, and that amounts are 
authorized to be made available to the President to make 
voluntary contributions to the United Nations Children's Fund 
to achieve the purposes of this subsection. Paragraph two of 
subsection 246(b) authorizes the President to provide 
assistance for programs in developing countries to provide 
employment training and related services for orphans and other 
vulnerable children, especially in developing countries heavily 
affected by HIV/AIDS.
    Section 247, ``Assistance to Protect and Promote 
Inheritance Rights,'' is divided into two subsections.
    Section 247(a) includes a finding that orphans and other 
vulnerable children in developing countries, particularly 
children who are orphaned as a result of AIDS, are routinely 
denied their inheritance or encounter difficulties in claiming 
the land and other property which they have inherited.
    Section 247(b) authorizes the President to provide 
assistance in support of programs in developing countries to 
protect and promote the inheritance rights of orphans and other 
vulnerable children, particularly young girls and children who 
are orphaned as a result of AIDS.
    Section 248, ``Administration of Assistance,'' includes six 
subsections.
    Section 248(a) establishes within the United States Agency 
for International Development an Office for Orphans and Other 
Vulnerable Children, which shall be headed by a Director who 
shall be appointed by the Administrator of the Agency. 
Paragraph two of subsection 248(a) establishes that the office 
shall be responsible for carrying out this title.
    Section 248(b) establishes that the Director of the Office 
established in section 248(a) shall be responsible for 
reviewing or approving all applications submitted to the United 
States Agency for International Development for assistance 
under this title, including applications submitted to field 
missions of the Agency.
    Section 248(c) establishes that in providing assistance 
under title V, priority should be given to assistance for 
developing countries in which the rate of HIV infection, as 
reported in the most recent epidemiological data for that 
country compiled by the United Nations Joint Programme on HIV/
AIDS (UNAIDS), is at least 5 percent among women attending 
prenatal clinics or more than 15 percent among individuals in 
groups with high-risk behavior.
    Section 248(d) requires that assistance under this title 
shall be provided in the form of grants, cooperative 
agreements, or contracts; contributions to international 
organizations; or assistance to the governments of developing 
countries.
    Section 248(e) requires that the provision of assistance 
under title V for children who are orphaned as a result of HIV/
AIDS, or are children with HIV/AIDS, shall be undertaken in a 
manner that is consistent with assistance authorized under 
section 104A of this act and assistance relating to HIV/AIDS 
authorized under the United States Leadership Against HIV/AIDS, 
Tuberculosis, and Malaria Act of 2003 (Public Law 108-25).
    Section 248(f) requires that the Director of the Office 
shall be responsible for reviewing or approving each component 
of the annual plan of a mission, bureau, or other office of the 
United States Agency for International Development as the 
component relates to assistance for orphans and other 
vulnerable children in developing countries; and each program, 
project, or activity relating to such assistance; and that the 
Director of the Office shall be responsible for ensuring 
coordination of all United States Government programs to 
provide assistance for orphans and other vulnerable children in 
developing countries.
    Section 249, ``Monitoring System,'' is divided into two 
subsections.
    Section 249(a) states that in order to maximize the 
sustainable development impact of assistance authorized under 
this title, the President shall establish a monitoring system 
that meets the requirements of section 249(b).
    Section 249(b) establishes that the monitoring system 
required by section 249(a) shall establish performance goals 
for the assistance and express such goals in an objective and 
quantifiable form, to the extent feasible; shall establish 
performance indicators to be used in measuring or assessing the 
achievement of such performance goals; and shall provide a 
basis for recommendations for adjustments to the assistance to 
enhance the impact of the assistance.
    Section 250, ``Report,'' is divided into two subsections.
    Section 250(a) requires that not later than December 31, 
2005, and each December 31 thereafter, the President shall 
transmit to Congress a report that contains a detailed 
description of the implementation of title V for the previous 
fiscal year.
    Section 250(b) establishes that the report required by 
section 250(a) shall contain the information on each grant, 
cooperative agreement, contract, contribution, or other form of 
assistance awarded or entered into under this title, including 
the amount of the grant, cooperative agreement, contract, 
contribution, or other form of assistance, the name of each 
recipient and each developing country with respect to which 
projects or activities under the grant, cooperative agreement, 
contract, contribution, or other form of assistance were 
carried out, and the approximate number of orphans and other 
vulnerable children who received assistance under the projects 
or activities; and the results of the monitoring system with 
respect to the grant, cooperative agreement, contract, 
contribution, or other form of assistance. Section 250(b) also 
requires the same information for each grant, cooperative 
agreement, contract, contribution, or other form of assistance 
awarded or entered into under any provision of law other than 
title V for assistance for orphans and other vulnerable 
children in developing countries. Section 250(b) requires any 
other appropriate information relating to the needs of orphans 
and other vulnerable children in developing countries that 
could be addressed through the provision of assistance under 
this title or under any other provision of law.
    Section 251, ``Authorization of Appropriations; Additional 
Provisions,'' is divided into two subsections.
    Section 251(a) authorizes that of the amounts made 
available to carry out Public Law 108-25 or any other provision 
of law under which assistance is authorized for orphans and 
other vulnerable children in developing countries, there are 
authorized to be appropriated to the President to carry out 
this title such sums as may be necessary for each of the fiscal 
years 2005 and 2006.
    Section 251(b) establishes that amounts appropriated 
pursuant to the authorization of appropriations under section 
251(a) are authorized to remain available until expended and 
are in addition to amounts otherwise available for such 
purposes; and that not less than 60 percent of amounts 
appropriated pursuant to the authorization of appropriations 
under section 251(a) for a fiscal year (other than amounts made 
available for assistance to eliminate school fees and other 
costs of education pursuant to section 246) shall be provided 
through United States or indigenous private voluntary 
organizations that implement programs on the community level. 
Section 251(b) establishes that amounts provided by for-profit 
entities to not-for-profit entities from assistance under this 
title shall not be considered for purposes of satisfying the 
requirement of this paragraph. Paragraph 3 of section 251(b) 
establishes that notwithstanding any other provision of law, 
amounts made available for assistance for orphans or other 
vulnerable children in developing countries under any provision 
of law other than this title may be provided to further the 
purposes of this title; and that to the extent such assistance 
is provided, the President shall include, as part of the report 
required under section 250, a detailed description of such 
assistance and, to the extent applicable, the information 
required by section 250(b)(1)(A) with respect to such 
assistance.
    Section 252 includes six definitions used throughout title 
V.

                        New Advisory Committees

    H.R. 4061 establishes no new advisory committees.

                    Congressional Accountability Act

    H.R. 4061 does not apply to the legislative branch.

                            Federal Mandates

    H.R. 4061 imposes no Federal mandates.

         Changes in Existing Law Made by the Bill, as Reported

    In compliance with clause 3(e) of rule XIII of the Rules of 
the House of Representatives, changes in existing law made by 
the bill, as reported, are shown as follows (existing law 
proposed to be omitted is enclosed in black brackets, new 
matter is printed in italics, existing law in which no change 
is proposed is shown in roman):

                     FOREIGN ASSISTANCE ACT OF 1961



           *       *       *       *       *       *       *
PART I

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Chapter 2--Other Programs

           *       *       *       *       *       *       *


                [Title V--Disadvantaged Children in Asia

    [Sec. 241. Assistance to Certain Disadvantaged Children in 
Asia.--(a) The Congress recognizes the humanitarian needs of 
disadvantaged children in Asian countries where there has been 
or continues to be a heavy presence of United States military 
and related personnel in recent years. Moreover, the Congress 
finds that inadequate provision has been made for the care and 
welfare of such disadvantaged children, particularly those 
fathered by the United States citizens.
    [(b) Accordingly, the President is authorized to expend up 
to $3,000,000  of funds made available under chapter 1 of this 
part, in addition to funds otherwise available for such 
purposes, to help meet the needs of these disadvantaged 
children in Asia by assisting in the expansion and improvement 
of orphanages, hostels, day care centers, school feeding 
programs, and health, education, and welfare programs. 
Assistance provided under this section shall be furnished under 
the auspices of and by international organizations or private 
voluntary agencies operating within, and in cooperation with, 
the countries of Asia where these disadvantaged children 
reside.]

     Title V--Assistance for Orphans and Other Vulnerable Children

SEC. 241. FINDINGS; DECLARATION OF POLICY.

    (a) Findings.--Congress finds the following:
            (1) By 2010, HIV/AIDS will orphan more than 
        25,000,000 children worldwide.
            (2) Ongoing conflicts and civil wars in developing 
        countries are adversely affecting children in these 
        countries, the vast majority of whom currently do not 
        receive humanitarian assistance or other support from 
        the United States Government.
            (3) Although the United States Government currently 
        administers assistance programs for orphans and other 
        vulnerable children in developing countries, for fiscal 
        year 2002 the United States Agency for International 
        Development reported that the United States Government 
        provided assistance to only 462,000 such orphans and 
        other vulnerable children, or less than one-half of one 
        percent of the estimated 108,000,000 total number of 
        such orphans and other vulnerable children.
            (4) The United States Government should increase 
        its efforts to provide assistance for orphans and other 
        vulnerable children in developing countries, especially 
        those children affected by HIV/AIDS or conflict.
            (5) The United States Agency for International 
        Development should establish improved capacity to 
        deliver assistance to orphans and other vulnerable 
        children in developing countries through partnerships 
        with private voluntary organizations, including faith-
        based organizations.
            (6) Further, the United States Agency for 
        International Development should be the primary United 
        States Government agency responsible for identifying 
        and assisting orphans and other vulnerable children in 
        developing countries.
    (b) Declaration of Policy.--Congress, recognizing that 
prompt and appropriate action by the United States to assist 
orphans and other vulnerable children in developing countries 
is an important expression of the humanitarian concern and 
tradition of the people of the United States, affirms the 
willingness of the United States to assist such orphans and 
other vulnerable children--
            (1) by providing assistance for the purpose of 
        improving the health, nutritional, shelter, 
        educational, economic, and psychological status of 
        orphans and other vulnerable children in such 
        countries; and
            (2) by providing humanitarian and protection 
        assistance to such orphans and other vulnerable 
        children affected by conflict or civil strife.

SEC. 242. ASSISTANCE TO PROVIDE BASIC CARE.

    (a) Findings.--Congress finds the following:
            (1) The need for individuals and local 
        organizations in developing countries to assist 
        households headed by children is necessary due to the 
        increase in the number of such households. Millions of 
        children in these types of households lack basic care, 
        such as access to food and shelter.
            (2) When communities are responsible for raising 
        orphans, these children are cared for in a rich and 
        nurturing environment and remain connected to the 
        traditions and rituals of families and the community.
            (3) As the number of these children increases, the 
        ability of communities to provide basic care for such 
        children is limited. Assistance to support the 
        provision of such basic care is therefore necessary in 
        and of itself and also to facilitate the provision of 
        other types of assistance for such children under this 
        title.
    (b) Assistance.--
            (1) In general.--The President is authorized to 
        provide assistance for programs in developing countries 
        to provide basic care for orphans and other vulnerable 
        children.
            (2) Activities supported.--Assistance provided 
        under paragraph (1) should be used--
                    (A) to support individuals and local 
                organizations, including teachers, social 
                workers, and representatives from religious 
                institutions and nongovernmental organizations, 
                to mobilize their own resources through the 
                establishment of ``community care councils'' to 
                provide basic care for orphans and other 
                vulnerable children, including day care, food 
                assistance, protection assistance, and home 
                visits;
                    (B) to increase the capacity of community 
                care councils described in subparagraph (A) to 
                meet on a regular basis to identify orphans and 
                other vulnerable children and to facilitate the 
                provision of services; and
                    (C) to establish and operate centers in 
                such communities to provide basic care 
                described in subparagraph (A).
            (3) Definition.--In this subsection, the term 
        ``protection assistance'' means all appropriate 
        measures to promote the physical and psychological 
        security of an individual, provide equal access to 
        basic services for the individual, and safeguard the 
        legal and human rights and dignity of the individual.

SEC. 243. ASSISTANCE TO PROVIDE TREATMENT TO ORPHANS AND OTHER 
                    VULNERABLE CHILDREN WITH HIV/AIDS.

    (a) Findings.--Congress finds the following:
            (1) Approximately 2,500,000 children under the age 
        of 15 worldwide have HIV/AIDS. Every day another 2,000 
        children under the age of 15 are infected with HIV.
            (2) In 2002, approximately 2,500,000 children were 
        at risk for infection with HIV through mother-to-child 
        transmission, which includes transmission at any point 
        during pregnancy, labor, delivery, or breastfeeding.
            (3) To date, more than 4,000,000 children worldwide 
        are estimated to have died from AIDS, primarily 
        contracted through mother-to-child transmission. Every 
        year, approximately 700,000 babies are infected with 
        HIV, of which the majority are living in Africa.
            (4) In southern Africa HIV/AIDS is now the leading 
        cause of death among young children, accounting for 
        almost half of such deaths.
            (5) Research has shown conclusively that initiation 
        in a timely manner of antiretroviral therapy for 
        infants or young children with HIV/AIDS can preserve or 
        restore their immune functions, promote normal growth 
        and development, and prolong life.
            (6) Few international development programs 
        specifically target the treatment of children with HIV/
        AIDS in developing countries. Reasons for this include 
        the perceived low priority of pediatric treatment, a 
        lack of pediatric health care professionals, lack of 
        expertise and experience in pediatric drug dosing and 
        monitoring, the perceived complexity of pediatric 
        treatment, and mistaken beliefs regarding the risks and 
        benefits of pediatric treatment.
    (b) Assistance.--
            (1) In general.--The President is authorized to 
        provide assistance for the treatment of orphans and 
        other vulnerable children with HIV/AIDS in developing 
        countries.
            (2) Activities supported.--Assistance provided 
        under paragraph (1) should be used to carry out the 
        following activities:
                    (A) The treatment of orphans and other 
                vulnerable children with HIV/AIDS through the 
                provision of pharmaceuticals, including high-
                quality, low-cost antiretrovirals and other 
                therapies, including generically manufactured 
                pharmaceuticals where appropriate.
                    (B)(i) The recruitment and training of 
                individuals to provide the treatment described 
                in subparagraph (A), including the recruitment 
                and training of appropriate support personnel.
                    (ii) Such training should include 
                appropriate methodologies relating to initial 
                diagnosis, appropriate dosages of 
                pharmaceuticals, monitoring, medication 
                adherence techniques, and treatment for any 
                complications resulting from such 
                pharmaceuticals.
                    (C) Activities of medical laboratories 
                relating to the treatment described in 
                subparagraph (A), including assistance for the 
                purchase of necessary equipment.

SEC. 244. ASSISTANCE TO PROVIDE PSYCHOSOCIAL SUPPORT TO ORPHANS AND 
                    OTHER VULNERABLE CHILDREN AFFECTED BY HIV/AIDS.

    (a) Findings.--Congress finds the following:
            (1) Many children who are orphaned as a result of 
        AIDS blame themselves for the death of a parent and 
        many children are separated from siblings, sometimes 
        for life.
            (2) The trauma that results from the loss of a 
        parent as a result of AIDS can trigger behavior 
        problems of aggression or emotional withdrawal and 
        negatively affect a child's performance in school and 
        the child's social relations.
            (3) Children living in families affected by HIV/
        AIDS are often stigmatized, teased, and ostracized by 
        peers. In Uganda, some children who are orphaned as a 
        result of AIDS are called ``walking corpses'' and 
        discouraged from attending school.
            (4) Children living in families affected by HIV/
        AIDS who are most vulnerable are those children in 
        households headed by children. In these households, 
        trained community volunteers can play a major role 
        through home visits.
            (5) In many African countries, religious leaders 
        are mobilizing individuals and local organizations 
        within the community to identify and respond to the 
        psychosocial needs of those children affected by AIDS.
    (b) Assistance.--The President is authorized to provide 
assistance for programs in developing countries to provide 
mental health treatment and related services to orphans and 
other vulnerable children affected by HIV/AIDS.

SEC. 245. ASSISTANCE FOR SCHOOL FOOD PROGRAMS.

    (a) Findings.--Congress finds the following:
            (1) In 2004, it is estimated that 125,000,000 
        children worldwide do not attend school, in part 
        because of hunger and malnutrition, and the vast 
        majority of these children are young girls.
            (2) School food programs, including take-home 
        rations, in developing countries provide strong 
        incentives for parents to send their children to school 
        and ensure that they continue with their education. 
        School food programs may reduce short-term hunger, 
        improve cognitive functions, and enhance learning, 
        behavior, and achievement.
            (3) In 2004, more than 8,000,000 children in sub-
        Saharan Africa are underweight compared to 1994. 
        Malnutrition enhances the risk that orphans and other 
        vulnerable children will be at risk for illness and 
        infections, especially if these children are also 
        infected with HIV.
            (4) Healthy members of families affected by HIV/
        AIDS in developing countries often leave the workforce 
        to care for those family members with HIV/AIDS, which 
        compounds the problem of access to food for the family. 
        Food consumption has been shown to drop by as much as 
        40 percent in these families.
            (5)(A) Although a number of organizations seek to 
        meet the needs of children who are orphaned or 
        vulnerable as a result of HIV/AIDS, local communities 
        continue to be the primary providers of support for 
        these children.
            (B) According to a survey by the United States 
        Agency for International Development, orphans and other 
        vulnerable children relied on relatives for food 
        support 74 percent of the time and on friends for food 
        support 19 percent of the time.
    (b) Assistance.--
            (1) In general.--The President is authorized to 
        provide assistance for school food programs in 
        developing countries.
            (2) Activities supported.--Assistance provided 
        under paragraph (1) should be used to purchase local or 
        regional foodstuffs, where appropriate, for school food 
        programs.

SEC. 246. ASSISTANCE TO INCREASE EDUCATIONAL OPPORTUNITIES AND PROVIDE 
                    EMPLOYMENT TRAINING.

    (a) Findings.--Congress finds the following:
            (1) The lack of financial resources in families 
        affected by HIV/AIDS prevents many orphans and other 
        vulnerable children in developing countries from 
        attending school because of the requirement to pay 
        school fees and other costs of education.
            (2) Such children, in particular young girls, are 
        often forced to miss school in order to serve as 
        caregivers to relatives with HIV/AIDS or assume adult 
        responsibilities for providing for the family. Younger 
        children who lose a parent also lose the opportunity to 
        learn skills that they will need to support themselves 
        as they grow older.
            (3) According to the International Labor 
        Organization (ILO), approximately 250,000,000 children 
        and adolescents ages 5 to 14 in developing countries 
        are working part-time and approximately 120,000,000 
        children and adolescents ages 5 to 14 in developing 
        countries are working full-time.
            (4) In many regions of Africa and other developing 
        countries, non-formal education plays an important role 
        to provide children who are unable to attend school 
        with the employment and related life skills training 
        such children need to survive.
            (5) Many organizations in Africa, including faith-
        based organizations, provide employment and related 
        life skills training for older children to better 
        prepare them to serve as caregivers for younger 
        siblings.
            (6) Organizations that provide non-formal education 
        can assist the thousands of children in developing 
        countries who are not currently being assisted by 
        families or communities and are struggling to survive.
    (b) Assistance.--
            (1) Education assistance.--The President is 
        authorized to provide assistance for programs in 
        developing countries to increase enrollment in public 
        primary schools by eliminating school fees and other 
        costs of education, especially in developing countries 
        heavily affected by HIV/AIDS. Amounts made available to 
        carry out this paragraph are authorized to be made 
        available to the President to make voluntary 
        contributions to the United Nations Children's Fund to 
        achieve the purposes of this paragraph.
            (2) Employment training assistance.--The President 
        is authorized to provide assistance for programs in 
        developing countries to provide employment training and 
        related services for orphans and other vulnerable 
        children, especially in developing countries heavily 
        affected by HIV/AIDS.

SEC. 247. ASSISTANCE TO PROTECT AND PROMOTE INHERITANCE RIGHTS.

    (a) Finding.--Congress finds that orphans and other 
vulnerable children in developing countries, particularly 
children who are orphaned as a result of AIDS, are routinely 
denied their inheritance or encounter difficulties in claiming 
the land and other property which they have inherited.
    (b) Assistance.--The President is authorized to provide 
assistance in support of programs in developing countries to 
protect and promote the inheritance rights of orphans and other 
vulnerable children, particularly young girls and children who 
are orphaned as a result of AIDS.

SEC. 248. ADMINISTRATION OF ASSISTANCE.

    (a) Office for Orphans and Other Vulnerable Children.--
            (1) Establishment.--There is established within the 
        United States Agency for International Development an 
        Office for Orphans and Other Vulnerable Children 
        (hereafter in this title referred to as the 
        ``Office''), which shall be headed by a Director who 
        shall be appointed by the Administrator of the Agency.
            (2) Duties.--The Office shall be responsible for 
        carrying out this title.
    (b) Approval of Applications.--The Director of the Office 
shall be responsible for reviewing or approving all 
applications submitted to the United States Agency for 
International Development for assistance under this title, 
including applications submitted to field missions of the 
Agency.
    (c) Priority.--In providing assistance under this title, 
priority should be given to assistance for developing countries 
in which the rate of HIV infection, as reported in the most 
recent epidemiological data for that country compiled by the 
United Nations Joint Programme on HIV/AIDS (UNAIDS), is at 
least 5 percent among women attending prenatal clinics or more 
than 15 percent among individuals in groups with high-risk 
behavior.
    (d) Form of Assistance.--Assistance under this title shall 
be provided in the form of--
            (1) grants, cooperative agreements, or contracts;
            (2) contributions to international organizations; 
        or
            (3) assistance to the governments of developing 
        countries.
    (e) Coordination.--The provision of assistance under this 
title for children who are orphaned as a result of HIV/AIDS, or 
are children with HIV/AIDS, shall be undertaken in a manner 
that is consistent with assistance authorized under section 
104A of this Act and assistance relating to HIV/AIDS authorized 
under the United States Leadership Against HIV/AIDS, 
Tuberculosis, and Malaria Act of 2003 (Public Law 108-25).
    (f) Other Assistance.--
            (1) Review and approval of other usaid 
        assistance.--The Director of the Office shall be 
        responsible for reviewing or approving--
                    (A) each component of the annual plan of a 
                mission, bureau, or other office of the United 
                States Agency for International Development as 
                the component relates to assistance for orphans 
                and other vulnerable children in developing 
                countries; and
                    (B) each program, project, or activity 
                relating to such assistance.
            (2) Coordination of all u.s. government 
        assistance.--The Director of the Office shall be 
        responsible for ensuring coordination of all United 
        States Government programs to provide assistance for 
        orphans and other vulnerable children in developing 
        countries.

SEC. 249. MONITORING SYSTEM.

    (a) Establishment.--In order to maximize the sustainable 
development impact of assistance authorized under this title, 
the President shall establish a monitoring system that meets 
the requirements of subsection (b).
    (b) Requirements.--The requirements referred to in 
subsection (a) are the following:
            (1) The monitoring system establishes performance 
        goals for the assistance and expresses such goals in an 
        objective and quantifiable form, to the extent 
        feasible.
            (2) The monitoring system establishes performance 
        indicators to be used in measuring or assessing the 
        achievement of the performance goals described in 
        paragraph (1).
            (3) The monitoring system provides a basis for 
        recommendations for adjustments to the assistance to 
        enhance the impact of the assistance.

SEC. 250. REPORT.

    (a) Report.--Not later than December 31, 2005, and each 
December 31 thereafter, the President shall transmit to 
Congress a report that contains a detailed description of the 
implementation of this title for the previous fiscal year.
    (b) Contents.--The report shall contain the following 
information:
            (1) For each grant, cooperative agreement, 
        contract, contribution, or other form of assistance 
        awarded or entered into under this title--
                    (A) the amount of the grant, cooperative 
                agreement, contract, contribution, or other 
                form of assistance, the name of each recipient 
                and each developing country with respect to 
                which projects or activities under the grant, 
                cooperative agreement, contract, contribution, 
                or other form of assistance were carried out, 
                and the approximate number of orphans and other 
                vulnerable children who received assistance 
                under the projects or activities; and
                    (B) the results of the monitoring system 
                with respect to the grant, cooperative 
                agreement, contract, contribution, or other 
                form of assistance.
            (2) For each grant, cooperative agreement, 
        contract, contribution, or other form of assistance 
        awarded or entered into under any provision of law 
        other than this title for assistance for orphans and 
        other vulnerable children in developing countries, the 
        information described in paragraph (1)(A).
            (3) Any other appropriate information relating to 
        the needs of orphans and other vulnerable children in 
        developing countries that could be addressed through 
        the provision of assistance under this title or under 
        any other provision of law.

SEC. 251. AUTHORIZATION OF APPROPRIATIONS; ADDITIONAL PROVISIONS.

    (a) Authorization of Appropriation.--
            (1) In general.--Of the amounts made available to 
        carry out the provisions of law described in paragraph 
        (2), there are authorized to be appropriated to the 
        President to carry out this title such sums as may be 
        necessary for each of the fiscal years 2005 and 2006.
            (2) Provisions of law.--The provisions of law 
        referred to in paragraph (1) are the following:
                    (A) The United States Leadership Against 
                HIV/AIDS, Tuberculosis, and Malaria Act of 2003 
                (Public Law 108-25) and the amendments made by 
                that Act.
                    (B) Any other provision of law under which 
                assistance is authorized for orphans and other 
                vulnerable children in developing countries.
    (b) Additional Provisions.--
            (1) Availability.--Amounts appropriated pursuant to 
        the authorization of appropriations under subsection 
        (a) are authorized to remain available until expended 
        and are in addition to amounts otherwise available for 
        such purposes.
            (2) Minimum funding requirement.--Not less than 60 
        percent of amounts appropriated pursuant to the 
        authorization of appropriations under subsection (a) 
        for a fiscal year (other than amounts made available 
        for assistance to eliminate school fees and other costs 
        of education pursuant to section 246) shall be provided 
        through United States or indigenous private voluntary 
        organizations that implement programs on the community 
        level. Amounts provided by for-profit entities to not-
        for-profit entities from assistance under this title 
        shall not be considered for purposes of satisfying the 
        requirement of this paragraph.
            (3) Assistance under other provisions of law.--
                    (A) In general.--Notwithstanding any other 
                provision of law, amounts made available for 
                assistance for orphans or other vulnerable 
                children in developing countries under any 
                provision of law other than this title may be 
                provided to further the purposes of this title.
                    (B) Report.--To the extent assistance 
                described in subparagraph (A) is provided in 
                accordance with such subparagraph, the 
                President shall include, as part of the report 
                required under section 250, a detailed 
                description of such assistance and, to the 
                extent applicable, the information required by 
                subsection (b)(1)(A) of such section with 
                respect to such assistance.

SEC. 252. DEFINITIONS.

    In this title:
            (1) AIDS.--The term ``AIDS'' has the meaning given 
        the term in section 104A(g)(1) of this Act.
            (2) Children.--The term ``children'' means persons 
        who have not attained the age of 18.
            (3) HIV.--The term ``HIV'' has the meaning given 
        the term in section 104A(g)(2) of this Act.
            (4) HIV/AIDS.--The term ``HIV/AIDS'' has the 
        meaning given the term in section 104A(g)(3) of this 
        Act.
            (5) Orphan.--The term ``orphan'' means a child 
        deprived by death of one or both parents.
            (6) Vulnerable children.--The term ``vulnerable 
        children'' includes children who are neglected, 
        destitute, abandoned, homeless, disabled, suffering 
        from malnutrition, are sexually exploited or abused, or 
        are displaced or otherwise adversely affected by armed 
        conflict.

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