The following is a report prepared by the Congressional Budget Office. It has been coverted to a text-only format below by GovTrack.

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                      CONGRESSIONAL BUDGET OFFICE
                            COST ESTIMATE

                                                                               M arch 5, 2008



                                       H.R. 5501
    Tom Lantos and Henry J. Hyde U.S. Global Leadership Against
   HIV/AIDS, Tuberculosis, and Malaria Reauthorization Act of 2008

             As ordered reported by the House Committee on Foreign Affairs
                                 on February 28, 2008



SUMMARY

H.R. 5501 would reauthorize several assistance programs aimed at preventing and treating
HIV/AIDS, tuberculosis, and malaria in other countries. For those programs, the bill would
authorize the appropriation of $10 billion a year over the 2009-2013 period. CBO estimates
that implementing H.R. 5501 would cost $1.5 billion in 2009 and $35 billion over the 2009-
2013 period, assuming appropriation of the authorized amounts. Enacting the bill would not
affect direct spending or receipts.

H.R. 5501 contains no intergovernmental or private-sector mandates as defined in the
Unfunded Mandates Reform Act (UMRA) and would not affect the budgets of state, local,
or tribal governments.


ESTIMATED COST TO THE FEDERAL GOVERNMENT

The estimated budgetary impact of H.R. 5501 is shown in the following table. The costs of
this legislation fall within budget functions 150 (international affairs) and 550 (health). For
this estimate, CBO assumes that the bill will be enacted by September 30, 2008, that the
authorized amounts are appropriated for each year, and that outlays will follow historical
spending patterns for the existing programs.
                                                   By Fiscal Year, in Millions of Dollars
                                          2009      2010            2011          2012       2013


                       CHANGES IN SPENDING SUBJECT TO APPROPRIATION

HIV/AIDS, Tuberculosis, and Malaria
Programs
   Authorization Level                   10,000     10,000       10,000         10,000      10,000
   Estimated Outlays                      1,392      6,392        8,262          9,082       9,482

Contributions to Vaccine Funds
  Estimated Authorization Level            108        108           108            158        158
  Estimated Outlays                        108        108           108            158        158

Total Changes
   Estimated Authorization Level         10,108     10,108       10,108         10,158      10,158
   Estimated Outlays                      1,500      6,500        8,370          9,240       9,640




BASIS OF ESTIMATE

Section 401 of H.R. 5501 would authorize the appropriation of $10 billion each year from
2009 through 2013. Those funds would be used to operate and expand the existing assistance
programs that provide grants and contributions to organizations and global funds devoted to
treating the effects of HIV/AIDS, tuberculosis, and malaria, and to preventing the
transmission of those diseases. Those programs, which received a total of $3 billion in
appropriations for 2008, are run by the Department of State, the United States Agency for
International Development (USAID), and the Department of Health and Human Services.

Section 203 would authorize the appropriation of such sums as may be necessary to make
contributions for research and development of various vaccines. Based on information from
USAID on the current amount of contributions to those funds (about $100 million in 2008)
and the amount needed to fund the final stages of development for a tuberculosis vaccine,
CBO estimates that implementing section 203 would cost $640 million over the 2009-2013
period.

B ased on information from the Department of State, CBO estimates that the amount
authorized to be appropriated is sufficient to fund the expanded requirements. Because it
will take some time to expand existing programs and develop new procedures and activities,
CBO estimates that implementing this bill would cost $1.5 billion in 2009 and about
$35 billion over the 2009-2013 period. Most of the additional amounts from the authorized
funding would be spent by 2018.

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INTERGOVERNMENTAL AND PRIVATE-SECTOR IMPACT

H.R. 5501 contains no intergovernmental or private-sector mandates as defined in UMRA
and would not affect the budgets of state, local, or tribal governments.


ESTIMATE PREPARED BY:

F ederal Costs: Michelle S. Patterson
Impact on State, Local, and Tribal Governments: Neil Hood
Impact on the Private Sector: MarDestinee C. Perez


ESTIMATE APPROVED BY:

P eter H. Fontaine
Assistant Director for Budget Analysis




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