S. 1340 would require the U.S. Agency for International Development (USAID) to provide certain foreign assistance to the Democratic Republic of the Congo (DRC) to address the recent Ebola outbreak. Under current law, the United States can provide humanitarian assistance such as medical supplies to the DRC. However, it is prohibited from providing other foreign assistance such as support for medical personnel, community outreach programs, and infrastructure improvements to that country because its government does not meet the minimum standards to combat human trafficking as required by the Trafficking Victims Protection Act of 2000 (TVPA). While the Administration may waive that restriction, it has not done so.
Before the TVPA restrictions were applied to the DRC in 2018, USAID provided an average of $130 million annually over the previous five years for health-related assistance to that country. Under the bill, CBO estimates that the agency would use about 50 percent of that amount for foreign assistance to address the Ebola outbreak in the eastern region of the DRC. CBO expects the other 50 percent would be for purposes unrelated to Ebola in the western region of the country; USAID would not be required to provide that assistance as a result of enacting this bill. Thus, CBO estimates that implementing S. 1340 would cost $70 million over the 2020-2024 period; such spending would be subject to the availability of appropriated funds (see Table 1).
This estimate is uncertain primarily because it is not clear what requirements would be established for health-related assistance provided to the DRC. Other factors that may contribute to the estimate’s uncertainty include the unstable security situation in that country, community resistance to vaccinations, inadequate infrastructure, outbreaks of other infectious diseases (such as malaria, cholera, and measles), and movement of the population across borders. CBO also cannot predict whether the Administration will waive the restrictions on foreign assistance to the DRC.