#aacth ,,congress  #ast ,session  ,s4   
#aede  ,,an ,,act  ,to extend           
authorities related to global           
,,hiv_/,,aids and to promote oversight  
of ,united ,states programs4  #a4 ,short
 title ,this ,act may be cited as the   
,,pepfar ,stewardship and ,oversight    
,act of #bjac4  #b4 ,inspector ,general 
oversight ,section #aja7;f77#a7 of the  
,united ,states ,leadership ,against    
,,hiv_/,,aids1 ,tuberculosis1 and       
,malaria ,act of #bjjc 7#bb ,u4,s4,c4   
#gfaa7;f77#a77 is amended-- 7#a7 in     
subparagraph 7,a71 by striking #e       
coordinated annual plans for oversight  
activity in each of the fiscal years    
#bjji through #bjac and inserting       
coordinated annual plans for oversight  
activity in each of the fiscal years    
#bjji through #bjah2 and  7#b7 in       
subparagraph 7,c7-- 7,a7 in clause      
7ii7-- 7i7 in the heading1 by striking  
,subsequent and inserting #bjaj through 
#bjac2 and  7ii7 by striking the last   
four plans and inserting the plans for  

fiscal years #bjaj through #bjac2 and   
7,b7 by adding at the end the following 
new clause3  7iii7 #bjad plan ,the plan 
developed under subparagraph 7,a7 for   
fiscal year #bjad shall be completed not
 later than #fj days after the date of  
the enactment of the ,,pepfar           
,stewardship and ,oversight ,act of     
#bjac4  7iv7 ,subsequent plans ,each of 
the last four plans developed under     
subparagraph 7,a7 shall be completed not
 later than #cj days before each of the 
fiscal years #bjae through #bjah1       
respectively4  4  #c4 ,annual treatment 
study  7a7 ,annual study2 message       
,section #aja7;g7 of the ,united ,states
 ,leadership ,against ,,hiv_/,,aids1    
,tuberculosis1 and ,malaria ,act of     
#bjjc 7#bb ,u4,s4,c4 #gfaa7;g77 is      
amended-- 7#a7 in paragraph 7#a71 by    
striking through ,september #cj1 #bjac  
and inserting through ,september #cj1   
#bjai2  7#b7 by redesignating paragraph 
7#b7 as paragraph 7#c72  7#c7 by        
inserting after paragraph 7#a7 the      

following new paragraph3  7#b7 #bjac    
through #bjah studies ,the studies      
required to be submitted by ,september  
#cj1 #bjad1 and annually thereafter     
through ,september #cj1 #bjah1 shall    
include1 in addition to the elements set
 forth under paragraph 7#a71 the        
following elements3 7,a7 ,a plan for    
conducting cost studies of ,united      
,states assistance under section #ajd;,a
 of the ,foreign ,assistance ,act of    
#aifa 7#bb ,u4,s4,c4 #baea;b-#b7 in     
partner countries1 taking into account  
the goal for more systematic collection 
of data1 as well as the demands of such 
analysis on available human and fiscal  
resources4  7,b7 ,a comprehensive and   
harmonized expenditure analysis by      
partner country1 including-- 7i7 an     
analysis of ,global ,fund and national  
partner spending and comparable data    
across ,united ,states1 ,global ,fund1  
and national partner spending2 or  7ii7 
where providing such comparable data is 
not currently practicable1 an           

explanation of why it is not currently  
practicable1 and when it will be        
practicable4  2 and  7#d7 by adding at  
the end the following new paragraph3    
7#d7 ,partner country defined ,in this  
subsection1 the term partner country    
means a country with a minimum ,united  
,states ,government investment of       
,,hiv_/,,aids assistance of at least    
#e1jjj1jjj in the prior fiscal year4  4 
#d4 ,participation in the ,global ,fund 
to fight ,,aids1 ,tuberculosis1 and     
,malaria  7a7 ,limitation ,section      
#bjb7;d77#d7 of the ,united ,states     
,leadership ,against ,,hiv_/,,aids1     
,tuberculosis1 and ,malaria ,act of     
#bjjc 7#bb ,u4,s4,c4 #gfbb7;d77#d77 is  
amended-- 7#a7 in subparagraph 7,a7--   
7,a7 in clause 7i71 by striking #bjac   
and inserting #bjah2  7,b7 in clause    
7ii7-- 7i7 by striking #bjac and        
inserting #bjah2 and  7ii7 by striking  
the last two sentences2 and  7,c7 in    
clause 7vi71 by striking #bjac and      
inserting #bjah2 and  7#b7 in           

subparagraph 7,b7-- 7,a7 by striking    
under this subsection each place it     
appears2  7,b7 in clause 7ii71 by       
striking pursuant to the authorization  
of appropriations under section #dja and
 inserting to carry out section #ajd;,a 
of the ,foreign ,assistance ,act of     
#aifa2 and  7,c7 in clause 7iv71 by     
striking #bjac and inserting #bjah4  7b7
 ,withholding funds ,section            
#bjb7;d77#e7 of the ,united ,states     
,leadership ,against ,,hiv_/,,aids1     
,tuberculosis1 and ,malaria ,act of     
#bjjc 7#bb ,u4,s4,c4 #gfbb7;d77 is      
amended by-- 7#a7 in paragraph 7#e7--   
7,a7 by striking #bjac and inserting    
#bjah2  7,b7 in subparagraph 7,c7-- 7i7 
by inserting in an open1 machine        
readable format after site2  7ii7 by    
amending clause 7v7 to read as follows3 
7v7 a regular collection1 analysis1 and 
reporting of performance data and       
funding of grants of the ,global ,fund1 
which covers all principal recipients   
and all subrecipients on the fiscal     

cycle of each grant1 and includes the   
distribution of resources1 by grant and 
principal recipient and subrecipient1   
for prevention1 care1 treatment1 drugs1 
and commodities purchase1 and other     
purposes as practicable2  2  7,c7 in    
subparagraph 7,d77ii71 by inserting 1 in
 an open1 machine readable format1 after
 audits2  7,d7 in subparagraph 7,e71 by 
inserting 1 in an open1 machine readable
 format1 after publicly2  7,e7 in       
subparagraph 7,f7-- 7i7 in clause 7i71  
by striking 2 and and inserting a       
semicolon2 and  7ii7 by striking clause 
7ii7 and inserting the following new    
clauses3  7ii7 all principal recipients 
and subrecipients and the amount of     
funds disbursed to each principal       
recipient and subrecipient on the fiscal
 cycle of the grant2  7iii7 expenditure 
data-- 7,i7 tracked by principal        
recipients and subrecipients by program 
area1 where practicable1 prevention1    
care1 and treatment and reported in a   
format that allows comparison with other

 funding streams in each country2 or    
7,,ii7 if such expenditure data is not  
available1 outlay or disbursement data1 
and an explanation of progress made     
toward providing such expenditure data2 
and  7iv7 high-quality grant performance
 evaluations measuring inputs1 outputs1 
and outcomes1 as appropriate1 with the  
goal of achieving outcome reporting2  2 
and  7,f7 by amending subparagraph 7,g7 
to read as follows3  7,g7 has published 
an annual report on a publicly available
 ,web site in an open1 machine readable 
format1 that includes-- 7i7 a list of   
all countries imposing import duties and
 internal taxes on any goods or services
 financed by the ,global ,fund2  7ii7 a 
description of the types of goods or    
services on which the import duties and 
internal taxes are levied2  7iii7 the   
total cost of the import duties and     
internal taxes2  7iv7 recovered import  
duties or internal taxes2 and  7v7 the  
status of country status-agreements2  4 
#e4 ,annual report ,section #ajd;,a7f7  

of the ,foreign ,assistance ,act of     
#aifa 7#bb ,u4,s4,c4 #baea;b-#b7;f77 is 
amended to read as follows3  7f7 ,annual
 report  7#a7 ,in general ,not later    
than ,february #ae1 #bjad1 and annually 
thereafter1 the ,president shall submit 
to the ,committee on ,foreign ,relations
 of the ,senate and the ,committee on   
,foreign ,affairs of the ,house of      
,representatives a report in an open1   
machine readable format1 on the         
implementation of this section for the  
prior fiscal year4  7#b7 ,report due in 
#bjad ,the report due not later than    
,february #ae1 #bjad1 shall include the 
elements required by law prior to the   
enactment of the ,,pepfar ,stewardship  
and ,oversight ,act of #bjac4  7#c7     
,report elements ,each report submitted 
after ,february #ae1 #bjad1 shall       
include the following3 7,a7 ,a          
description based on internationally    
available data1 and where practicable   
high-quality country-based data1 of the 
total global burden and need for        

,,hiv_/,,aids prevention1 treatment1 and
 care1 including-- 7i7 estimates by     
partner country of the global burden and
 need2 and  7ii7 ,,hiv incidence1       
prevalence1 and ,,aids deaths for the   
reporting period4  7,b7 ,reporting on   
annual targets across prevention1       
treatment1 and care interventions in    
partner countries1 including-- 7i7 a    
description of how those targets are    
designed to-- 7,i7 ensure that the      
annual increase in new patients on      
antiretroviral treatment exceeds the    
number of annual new ,,hiv infections2  
7,,ii7 reduce the number of new ,,hiv   
infections below the number of deaths   
among persons infected with ,,hiv2 and  
7,,iii7 achieve an ,,aids-free          
generation2  7ii7 national targets      
across prevention1 treatment1 and care  
that are-- 7,i7 established by partner  
countries2 or  7,,ii7 where such        
national partner country-developed      
targets are unavailable1 a description  
of progress towards developing national 

partner country targets2 and  7iii7     
bilateral programmatic targets across   
prevention1 treatment1 and care1        
including-- 7,i7 the number of adults   
and children to be directly supported on
 ,,hiv treatment under ,united          
,states-funded programs2  7,,ii7 the    
number of adults and children to be     
otherwise supported on ,,hiv treatment  
under ,united ,states-funded programs2  
and  7,,iii7 other programmatic targets 
for activities directly and otherwise   
supported by ,united ,states-funded     
programs4  7,c7 ,a description1 by      
partner country1 of ,,hiv_/,,aids       
funding from all sources1 including     
funding levels from partner countries1  
other donors1 and the private sector1 as
 practicable4  7,d7 ,a description of   
how ,united ,states-funded programs1 in 
conjunction with the ,global ,fund1     
other donors1 and partner countries1    
together set targets1 measure progress1 
and achieve positive outcomes in partner
 countries4  7,e7 ,an annual assessment 

of outcome indicator development1       
dissemination1 and performance for      
programs supported under this section1  
including ongoing corrective actions to 
improve reporting4  7,f7 ,a description 
and explanation of changes in related   
guidance or policies related to         
implementation of programs supported    
under this section4  7,g7 ,an assessment
 and quantification of progress over the
 reporting period toward achieving the  
targets set forth in subparagraph 7,b71 
including-- 7i7 the number1 by partner  
country1 of persons on ,,hiv treatment1 
including specifically-- 7,i7 the number
 of adults and children on ,,hiv        
treatment directly supported by ,united 
,states-funded programs2 and  7,,ii7 the
 number of adults and children on ,,hiv 
treatment otherwise supported by ,united
 ,states-funded programs2  7ii7 ,,hiv   
treatment coverage rates by partner     
country2  7iii7 the net increase in     
persons on ,,hiv treatment by partner   
country2  7iv7 new infections of ,,hiv  

by partner country2  7v7 the number of  
,,hiv infections averted2  7vi7         
antiretroviral treatment program        
retention rates by partner country1     
including-- 7,i7 performance against    
annual targets for program retention2   
and  7,,ii7 the retention rate of       
persons on ,,hiv treatment directly     
supported by ,united ,states-funded     
programs2 and  7vii7 a description of   
supportive care4  7,h7 ,a description of
 partner country and ,united            
,states-funded ,,hiv_/,,aids prevention 
programs and policies1 including-- 7i7  
an assessment by country of progress    
towards targets set forth in            
subparagraph 7,b71 with a detailed      
description of the metrics used to      
assess-- 7,i7 programs to prevent mother
 to child transmission of ,,hiv_/,,aids1
 including coverage rates2  7,,ii7      
programs to provide or promote voluntary
 medical male circumcision1 including   
coverage rates2  7,,iii7 programs for   
behavior-change2 and  7,,iv7 other      

programmatic activities to prevent the  
transmission of ,,hiv2  7ii7            
antiretroviral treatment as prevention2 
and  7iii7 a description of any new     
preventative interventions or           
methodologies4  7,i7 ,a description of  
the goals1 scope1 and measurement of    
program efforts aimed at women and      
girls4  7,j7 ,a description of the      
goals1 scope1 and measurement of program
 efforts aimed at orphans1 vulnerable   
children1 and youth4  7,k7 ,a           
description of the indicators and       
milestones used to assess effective1    
strategic1 and appropriately timed      
country ownership1 including-- 7i7 an   
explanation of the metrics used to      
determine whether the pace of any       
transition to such ownership is         
appropriate for that country1 given that
 country's level of readiness for such  
transition2  7ii7 an analysis of        
governmental and local nongovernmental  
capacity to sustain positive outcomes2  
7iii7 a description of measures taken to

 improve partner country capacity to    
sustain positive outcomes where needed2 
and  7iv7 for countries undergoing a    
transition to greater country ownership1
 a description of strategies to assess  
and mitigate programmatic and financial 
risk and to ensure continued quality of 
care for essential services4  7,l7 ,a   
description1 globally and by partner    
country1 of specific efforts to achieve 
and incentivize greater programmatic and
 cost effectiveness1 including-- 7i7    
progress toward establishing common     
economic metrics across prevention1 care
 and treatment with partner countries   
and the ,global ,fund2  7ii7 average    
costs1 by country and by core           
intervention2  7iii7 expenditure        
reporting in all program areas1         
supplemented with targeted analyses of  
the cost-effectiveness of specific      
interventions2 and  7iv7 import duties  
and internal taxes imposed on program   
commodities and services1 by country4   
7,m7 ,a description of partnership      

framework agreements with countries1 and
 regions where applicable1 including--  
7i7 the objectives and structure of     
partnership framework agreements with   
countries1 including-- 7,i7 how these   
agreements are aligned with national    
,,hiv_/,,aids plans and public health   
strategies and commitments of such      
countries2 and  7,,ii7 how these        
agreements incorporate a role for civil 
society2 and  7ii7 a description of what
 has been learned in advancing          
partnership framework agreements with   
countries1 and regions as applicable1 in
 terms of improved coordination and     
collaboration1 definition of clear roles
 and responsibilities of participants   
and signers1 and implications for how to
 further strengthen these agreements    
with mutually accountable measures of   
progress4  7,n7 ,a description of       
efforts and activities to engage new    
partners1 including faith-based1        
locally-based1 and ,united ,states      
minority-serving institutions4  7,o7 ,a 

definition and description of the       
differentiation between directly and    
otherwise supported activities1         
including specific efforts to clarify   
programmatic attribution and            
contribution1 as well as timelines for  
dissemination and implementation4  7,p7 
,a description1 globally and by country1
 of specific efforts to address         
co-infections and co-morbidities of     
,,hiv_/,,aids1 including-- 7i7 the      
number and percent of people in ,,hiv   
care or treatment who started           
tuberculosis treatment2 and  7ii7 the   
number and percentage of eligible ,,hiv 
positive patients starting isoniazid    
preventative therapy4  7,q7 ,a          
description of efforts by partner       
countries to train1 employ1 and retain  
health care workers1 including efforts  
to address workforce shortages4  7,r7 ,a
 description of program evaluations     
completed during the reporting period1  
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 7#d74  7#d7 ,common evaluation
 standards ,not later than ,february #a1
 #bjad1 the ,global ,,aids ,coordinator 
shall publish on a publically available 
,internet website the common evaluation 
standards of practice referred to in    
paragraph 7#c77,r74  7#e7 ,partner      
country defined ,in this subsection1 the
 term partner country means a country   
with a minimum ,united ,states          
,government investment of ,,hiv_/,,aids 
assistance of at least #e1jjj1jjj in the
 prior fiscal year4  4  #f4 ,allocation 
of funding  7a7 ,orphans and vulnerable 
children ,section #djc7;b7 of the       
,united ,states ,leadership ,against    
,,hiv_/,,aids1 ,tuberculosis1 and       
,malaria ,act of #bjjc 7#bb ,u4,s4,c4   
#gfgc7;b77 is amended-- 7#a7 by striking
 #bjac and inserting #bjah2 and  7#b7 by
 striking amounts appropriated pursuant 

to the authorization of appropriations  
under section #dja and inserting amounts
 appropriated or otherwise made         
available to carry out the provisions of
 section #ajd;,a of the ,foreign        
,assistance ,act of #aifa 7#bb ,u4,s4,c4
 #baea;b-#b74  7b7 ,funding allocation  
,section #djc7;c7 of the ,united ,states
 ,leadership ,against ,,hiv_/,,aids1    
,tuberculosis1 and ,malaria ,act of     
#bjjc 7#bb ,u4,s4,c4 #gfgc7;c77 is      
amended-- 7#a7 by striking #bjac and    
inserting #bjah2 and  7#b7 by striking  
amounts appropriated for bilateral      
global ,,hiv_/,,aids assistance pursuant
 to section #dja and inserting amounts  
appropriated or otherwise made available
 to carry out the provisions of section 
#ajd;,a of the ,foreign ,assistance ,act
 of #aifa 7#bb ,u4,s4,c4 #baea;b-#b74   
,passed the ,senate ,november #ah1      
#bjac4,secretary