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Appendix A Statement of Task As part of a two-step process, an ad hoc committee will undertake the first step to develop a plan for the assessment and evaluation of HIV/AIDS programs implemented under the U.S. Global Leadership Against HIV/AIDS, Tuberculosis, and Malaria Reauthorization Act of 2008 and issue a short report to the U.S. Congress on the plan's proposed design and budget by early 2010. The Institute of Medicine’s Board on Global Health and the Board on Children, Youth, and Families will undertake this consensus study jointly. The second step will involve the actual conduct of the assessment and evaluation of the programs as a separate project after congressional review of the plan's proposed design and budget is completed. (A) In its plan development, the committee will take cognizance of the following requirements for the congressionally mandated study, which must include: (i) an assessment of the performance of United States-assisted global HIV/AIDS programs; and (ii) an evaluation of the impact on health of prevention, treatment, and care efforts that are supported by United States funding, including multilateral and bilateral programs involving joint operations. (B) Further the committee should provide: (i) an assessment of progress toward prevention, treatment, and care targets; (ii) an assessment of the effects on health systems, including on the financing and management of health systems and the quality of service delivery and staffing; (iii) an assessment of efforts to address gender-specific aspects of HIV/AIDS, including gender related constraints to accessing services and addressing underlying social and economic vulnerabilities of women and men; (iv) an evaluation of the impact of treatment and care programs on 5-year survival rates, drug adherence, and the emergence of drug resistance; (v) an evaluation of the impact of prevention programs on HIV incidence in relevant population groups; (vi) an evaluation of the impact on child health and welfare of interventions authorized under this Act on behalf of orphans and vulnerable children; (vii) an evaluation of the impact of programs and activities authorized in this Act on child mortality; and (viii) recommendations for improving the programs referred to in subparagraph (A)(i). 143

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