109th CONGRESS
2d Session
S. 2765
To provide assistance to improve the health of newborns, children,
and mothers in developing countries, and for other purposes.
IN THE SENATE OF THE UNITED STATES
May 9, 2006
Mr. DODD (for himself and Mr. SMITH) introduced the following bill; which
was read twice and referred to the Committee on Foreign Relations
A BILL
To provide assistance to improve the health of newborns, children,
and mothers in developing countries, and for other purposes.
Be it enacted by the Senate and House of Representatives of the United
States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the `Child Health Investment for Long-term Development
(CHILD and Newborn) Act of 2006'.
SEC. 2. FINDINGS AND PURPOSES.
(a) Findings- Congress finds the following:
(1) Around the world, approximately 10.8 million children under the age
of five die each year, more than 30,000 per day, almost all in the developing
world.
(2) Each year in the developing world, four million newborns die in their
first four weeks of life.
(3) Sub-Saharan Africa, with only 10 percent of the world's population,
accounts for 43 percent of all deaths among children under the age of
five.
(4) Countries such as Afghanistan, Angola and Niger experience extreme
levels of child mortality, with 25 percent of children dying before their
fifth birthday.
(5) For children under the age of five in the developing world, preventable
or treatable diseases, such as measles, tetanus, diarrhea, pneumonia,
and malaria, are the most common causes of death.
(6) Throughout the developing world, the lack of basic health services,
clean water, adequate sanitation, and proper nutrition contribute significantly
to child mortality.
(7) Hunger and malnutrition contribute to over five million child deaths
annually.
(8) The lack of low-cost antibiotics and anti-malarial drugs contribute
to three million child deaths each year.
(9) Lack of access to health services results in 30 million children under
the age of one year going without necessary immunizations.
(10) Every year an estimated 250,000 to 500,000 vitamin A-deficient children
become blind, with one-half of such children dying within 12 months of
losing their sight.
(11) Iron deficiency, affecting over 30 percent of the world's population,
causes premature birth, low birth weight, and infections, elevating the
risk of death in children.
(12) Two-thirds of deaths of children under five years of age, or 7.1
million children, including three million newborn deaths, could be prevented
by low-cost, low-tech health and nutritional interventions.
(13) Exclusive breastfeeding--giving only breast milk for the first six
months of life--could prevent an estimated 1.3 million newborn and infant
deaths each year, primarily by protecting against diarrhea and pneumonia.
(14) An additional two million lives could be saved annually by providing
oral-rehydration therapy prepared with clean water.
(15) During the 1990s, successful immunization programs reduced polio
by 99 percent, tetanus deaths by 50 percent, and measles cases by 40 percent.
(16) Between 1998 and 2000, distribution of low-cost vitamin A supplements
saved an estimated one million lives.
(17) Expansion of clinical care of newborns and mothers, such as clean
delivery by skilled attendants, emergency obstetric care, and neonatal
resuscitation, can avert 50 percent of newborn deaths.
(18) Keeping mothers healthy is essential for child survival because illness,
complications, or maternal death during or following pregnancy increases
the risk for death in newborns and infants.
(19) Each year more than 525,000 women die from causes related to pregnancy
and childbirth, with 99 percent of these deaths occurring in developing
countries.
(20) The lifetime risk of an African woman dying from a complication related
to pregnancy or childbirth is 1 in 16, while the same risk for a woman
in a developed country is 1 in 2,800.
(21) Risk factors for maternal death in developing countries include early
pregnancy and childbirth, closely spaced births, infectious diseases,
malnutrition, and complications during childbirth.
(22) Birth spacing, access to preventive care, skilled birth attendants,
and emergency obstetric care can help reduce maternal mortality.
(23) The role of the United States in promoting child survival and maternal
health over the past three decades has resulted in millions of lives being
saved around the world.
(24) In 2000, the United States joined 188 other countries in supporting
eight Millennium Development Goals designed to achieve `a more peaceful,
prosperous and just world'.
(25) Two of the Millennium Development Goals call for a reduction in the
mortality rate of children under the age of five by two-thirds and a reduction
in maternal deaths by three-quarters by 2015.
(26) On September 14, 2005, President George W. Bush stated before the
leaders of the world: `To spread a vision of hope, the United States is
determined to help nations that are struggling with poverty. We are committed
to the Millennium Development Goals.'.
(b) Purposes- The purposes of this Act are to--
(1) authorize assistance to improve the health of newborns, children,
and mothers in developing countries, including by strengthening the capacity
of health systems and health workers;
(2) develop and implement a strategy to improve the health of newborns,
children, and mothers, including reducing child and maternal mortality,
in developing countries;
(3) to establish a task force to assess, monitor, and evaluate the progress
and contributions of relevant departments and agencies of the Government
of the United States in achieving the United Nations Millennium Development
Goals by 2015 for reducing the mortality of children under the age of
five by two-thirds and reducing maternal mortality by three-quarters in
developing countries.
SEC. 3. ASSISTANCE TO IMPROVE THE HEALTH OF NEWBORNS, CHILDREN, AND MOTHERS
IN DEVELOPING COUNTRIES.
(a) In General- Chapter 1 of part I of the Foreign Assistance Act of 1961
(22 U.S.C. 2151 et seq.) is amended--
(A) by striking paragraphs (2) and (3); and
(B) by redesignating paragraph (4) as paragraph (2);
(2) by redesignating sections 104A, 104B, and 104C as sections 104B, 104C,
and 104D, respectively; and
(3) by inserting after section 104 the following new section:
`SEC. 104A. ASSISTANCE TO IMPROVE THE HEALTH OF NEWBORNS, CHILDREN, AND
MOTHERS.
`(a) Authorization- Consistent with section 104(c), the President is authorized
to furnish assistance, on such terms and conditions as the President may
determine, to improve the health of newborns, children, and mothers in developing
countries.
`(b) Activities Supported- Assistance provided under subsection (b) shall,
to the maximum extent practicable, be used to carry out the following activities:
`(1) Activities to strengthen the capacity of health systems in developing
countries, including training for clinicians, nurses, technicians, sanitation
and public health workers, community-based health workers, midwives and
birth attendants, peer educators, and private sector enterprises.
`(2) Activities to provide health care access to underserved and marginalized
populations.
`(3) Activities to ensure the supply, logistical support, and distribution
of essential drugs, vaccines, commodities, and equipment to regional,
district, and local levels.
`(4) Activities to educate underserved and marginalized populations to
seek health care when appropriate, including clinical and community-based
activities.
`(5) Activities to integrate and coordinate assistance provided under
this section with existing health programs for--
`(A) the prevention of the transmission of HIV from mother-to-child
and other HIV/AIDS counseling, care, and treatment activities;
`(6) Activities to expand access to safe water and sanitation.
`(7) Activities to expand the use of and technical support for appropriate
technology to reduce acute respiratory infection from firewood smoke inhalation.
`(c) Guidelines- To the maximum extent practicable, programs, projects,
and activities carried out using assistance provided under this section
shall be--
`(1) carried out through private and voluntary organizations, as well
as faith-based organizations, giving priority to organizations that demonstrate
effectiveness and commitment to improving the health of newborns, children,
and mothers;
`(2) carried out with input by host countries, including civil society
and local communities, as well as other donors and multilateral organizations;
`(3) carried out with input by beneficiaries and other directly affected
populations, especially women and marginalized communities; and
`(4) designed to build the capacity of host country governments and civil
society organizations.
`(d) Annual Report- Not later than January 31 of each year, the President
shall transmit to Congress a report on the implementation of this section
for the prior fiscal year.
`(e) Definitions- In this section:
`(1) AIDS- The term `AIDS' has the meaning given the term in section 104B(g)(1)
of this Act.
`(2) HIV- The term `HIV' has the meaning given the term in section 104B(g)(2)
of this Act.
`(3) HIV/AIDS- The term `HIV/AIDS' has the meaning given the term in section
104B(g)(3) of this Act.'.
(b) Conforming Amendments- The Foreign Assistance Act of 1961 (22 U.S.C.
2151 et seq.) is amended--
(1) in section 104(c)(2) (as redesignated by subsection (a)(1)(B) of this
section), by striking `and 104C' and inserting `104C, and 104D';
(2) in section 104B (as redesignated by subsection (a)(2) of this section)--
(A) in subsection (c)(1), by inserting `and section 104A' after `section
104(c)';
(B) in subsection (e)(2), by striking `section 104B, and section 104C'
and inserting `section 104C, and section 104D'; and
(C) in subsection (f), by striking `section 104(c), this section, section
104B, and section 104C' and inserting `section 104(c), section 104A,
this section, section 104C, and section 104D';
(3) in subsection (c) of section 104C (as redesignated by subsection (a)(2)
of this section), by inserting `and section 104A' after `section 104(c)';
(4) in subsection (c) of section 104D (as redesignated by subsection (a)(2)
of this section), by inserting `and section 104A' after `section 104(c)';
and
(5) in the first sentence of section 119(c), by striking `section 104(c)(2),
relating to Child Survival Fund' and inserting `section 104A'.
SEC. 4. DEVELOPMENT OF STRATEGY TO IMPROVE THE HEALTH OF NEWBORNS, CHILDREN,
AND MOTHERS IN DEVELOPING COUNTRIES.
(a) Development of Strategy- The President shall develop a comprehensive
strategy to improve the health of newborns, children, and mothers, including
reducing newborn, child, and maternal mortality, in developing countries.
(b) Components- The strategy developed pursuant to subsection (a) shall
include the following:
(1) Programmatic areas and interventions providing maximum health benefits
to populations at risk as well as maximum reduction in mortality, including--
(A) costs and benefits of programs and interventions; and
(B) investments needed in identified programs and interventions to achieve
the greatest results.
(2) An identification of countries with priority needs for the five-year
period beginning on the date of the enactment of this Act based on--
(A) the neonatal mortality rate;
(B) the mortality rate of children under the age of five;
(C) the maternal mortality rate;
(D) the percentage of women and children with limited or no access to
basic health care; and
(E) additional criteria for evaluation such as--
(i) the percentage of one-year old children who are fully immunized;
(ii) the percentage of children under the age of five who sleep under
insecticide-treated bed nets;
(iii) the percentage of children under the age of five with fever
treated with anti-malarial drugs;
(iv) the percentage of children under the age of five who are covered
by vitamin A supplementation;
(v) the percentage of children under the age of five with diarrhea
who are receiving oral-rehydration therapy and continued feeding;
(vi) the percentage of children under the age of five with pneumonia
who are receiving appropriate care;
(vii) the percentage of the population with access to improved sanitation
facilities;
(viii) the percentage of the population with access to safe drinking
water;
(ix) the percentage of children under the age of five who are underweight
for their age;
(x) the percentage of births attended by skilled health care personnel;
(xi) the percentage of women with access to emergency obstetric care;
(xii) the potential for implementing newborn, child, and maternal
health interventions at scale; and
(xiii) the demonstrated commitment of countries to newborn, child,
and maternal health.
(3) A description of how United States assistance complements and leverages
efforts by other donors, as well as builds capacity and self-sufficiency
among recipient countries.
(4) An expansion of the Child Survival and Health Grants Program of the
United States Agency for International Development to provide additional
support programs and interventions determined to be efficacious and cost-effective
in improving health and reducing mortality.
(5) Enhanced coordination among relevant departments and agencies of the
Government of the United States engaged in activities to improve the health
of newborns, children, and mothers in developing countries.
(c) Report- Not later than 180 days after the date of the enactment of this
Act, the President shall transmit to Congress a report that contains the
strategy described in this section.
SEC. 5. INTERAGENCY TASK FORCE ON CHILD SURVIVAL AND MATERNAL HEALTH IN
DEVELOPING COUNTRIES.
(a) Establishment- There is established a task force to be known as the
Interagency Task Force on Child Survival and Maternal Health in Developing
Countries (in this section referred to as the `Task Force').
(1) IN GENERAL- The Task Force shall assess, monitor, and evaluate the
progress and contributions of relevant departments and agencies of the
Government of the United States in achieving the Millennium Development
Goals by 2015 for reducing the mortality of children under the age of
five by two-thirds and reducing maternal mortality by three-quarters in
developing countries, including by--
(A) identifying and evaluating programs and interventions that directly
or indirectly contribute to the reduction of child and maternal mortality
rates;
(B) assessing effectiveness of programs, interventions, and strategies
toward achieving the maximum reduction of child and maternal mortality
rates;
(C) assessing the level of coordination among relevant departments and
agencies of the Government of the United States, the international community,
international organizations, faith-based organizations, academic institutions,
and the private sector;
(D) assessing the contributions made by United States-funded programs
toward achieving the Millennium Development Goals;
(E) identifying the bilateral efforts of other nations and multilateral
efforts toward achieving the Millennium Development Goals; and
(F) preparing the annual report required by subsection (f).
(2) CONSULTATION- To the maximum extent practicable, the Task Force shall
consult with individuals with expertise in the matters to be considered
by the Task Force who are not officers or employees of the Government
of the United States, including representatives of United States-based
nongovernmental organizations (including faith-based organizations and
private foundations), academic institutions, private corporations, the
United Nations Children's Fund (UNICEF), and the World Bank.
(1) NUMBER AND APPOINTMENT- The Task Force shall be composed of the following
members:
(A) The Administrator of the United States Agency for International
Development.
(B) The Assistant Secretary of State for Population, Refugees and Migration.
(C) The Coordinator of United States Government Activities to Combat
HIV/AIDS Globally.
(D) The Director of the Office of Global Health Affairs of the Department
of Health and Human Services.
(E) The Under Secretary for Food, Nutrition and Consumer Services of
the Department of Agriculture.
(F) The Chief Executive Officer of the Millennium Challenge Corporation.
(G) The Director of the Peace Corps.
(H) Other officials of relevant departments and agencies of the Federal
Government who shall be appointed by the President.
(2) CHAIRPERSON- The Administrator of the United States Agency for International
Development shall serve as chairperson of the Task Force.
(d) Meetings- The Task Force shall meet on a regular basis, not less often
than quarterly, on a schedule to be agreed upon by the members of the Task
Force, and starting not later than 90 days after the date of the enactment
of this Act.
(e) Definition- In this subsection, the term `Millennium Development Goals'
means the key development objectives described in the United Nations Millennium
Declaration, as contained in United Nations General Assembly Resolution
55/2 (September 2000).
(f) Report- Not later than 120 days after the date of the enactment of this
Act, and not later than April 30 of each year thereafter, the Task Force
shall submit to Congress and the President a report on the implementation
of this section.
SEC. 6. AUTHORIZATION OF APPROPRIATIONS.
(a) In General- There are authorized to be appropriated to carry out this
Act, and the amendments made by this Act, $660,000,000 for fiscal year 2007
and $1,200,000,000 for each of the fiscal years 2008 through 2011.
(b) Availability of Funds- Amounts appropriated pursuant to the authorization
of appropriations under subsection (a) are authorized to remain available
until expended.
END
