```

[Congressional Bills 116th Congress]
[From the U.S. Government Publishing Office]
[H.R. 4864 Referred in Senate (RFS)]

<DOC>
116th CONGRESS
  2d Session
                                H. R. 4864

_______________________________________________________________________

                   IN THE SENATE OF THE UNITED STATES

                           September 23, 2020

Received; read twice and referred to the Committee on Foreign Relations

_______________________________________________________________________

                                 AN ACT

 
     To develop and implement policies to advance early childhood 
  development, to provide assistance for orphans and other vulnerable 
       children 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 ``Global Child Thrive Act of 2020''.

SEC. 2. FINDINGS.

    Congress finds the following:
            (1) According to a 2019 report from the United Nations 
        Inter-Agency Group for Child Mortality Estimation entitled 
        ``Levels & Trends in Child Mortality'', the annual number of 
        deaths among children younger than 15 years of age dropped by 
        56 percent between 1990 and 2018, from approximately 14,200,000 
        to approximately 6,200,000.
            (2) According to a 2016 article published in The Lancet 
        entitled ``Early childhood development: the foundation of 
        sustainable development''--
                    (A) an estimated 250,000,000 children in low-income 
                and middle-income countries suffer suboptimal 
                development due to poverty and stunting alone; and
                    (B) children who do not meet developmental 
                milestones are expected to lose about 25 percent of 
                their average yearly income once they become adults.
            (3) According to a report from the United Nations 
        Children's Fund (UNICEF), entitled ``The State of the World's 
        Children 2016: A fair chance for every child'', nearly 
        250,000,000 of the world's 650,000,000 primary school age 
        children do not master basic literacy and numeracy.
            (4) According to a 2018 report from the World Health 
        Organization entitled ``Nurturing Care for early childhood 
        development''--
                    (A) the environment in which a child grows has a 
                profound impact on future learning, behavior, and 
                health; and
                    (B) a country's economic diversity and growth could 
                be improved by investment in early childhood 
                development.
            (5) According to a 2017 UNICEF report entitled ``UNICEF's 
        Programme Guidance for Early Childhood Development'', nurturing 
        care, which is key to early childhood development, consists of 
        a core set of interrelated components, including--
                    (A) behaviors, attitudes, and knowledge about 
                caregiving, including health, hygiene care, and 
                feeding;
                    (B) stimulation, such as talking, singing, and 
                playing;
                    (C) responsiveness, such as early bonding, secure 
                attachment, trust, and sensitive communication; and
                    (D) safety, including routines, protection from 
                violence, abuse, neglect, harm, and environmental 
                pollution.
            (6) According to a 2016 report published in The Lancet 
        entitled ``Advancing Early Childhood Development: From Science 
        to Scale''--
                    (A) nurturing care from parents, relatives, and 
                other caregivers and services are formative experiences 
                for young children;
                    (B) programs promoting nurturing care can improve 
                early childhood development outcomes; and
                    (C) children who do not receive nurturing care 
                display negative development outcomes, such as greater 
                sensitivity to the effects of stress or behavioral 
                problems, especially children who do not receive 
                nurturing care before their second birthday.
            (7) According to the ``Advancing Protection and Care for 
        Children in Adversity 2019-2023: A U.S. Government Strategy for 
        International Assistance'', children who live without 
        protective family care, in abusive households, on the streets, 
        or in institutions, or who are trafficked, are participating in 
        armed groups, or are being exploited for their labor are more 
        likely to be exposed to violence, exploitation, abuse, and 
        neglect.
            (8) According to a 2017 UNICEF report entitled ``Early 
        Moments Matter for every child'', violence, abuse, neglect, and 
        traumatic experiences produce toxic stress that limits neural 
        connectivity in developing brains.
            (9) According to a 2014 working paper from the National 
        Scientific Council on the Developing Child at Harvard 
        University entitled ``Excessive Stress Disrupts the 
        Architecture of the Developing Brain''--
                    (A) situations that produce toxic stress increase 
                the production of cortisol in a child's brain, which 
                disrupts its healthy development; and
                    (B) chronic stress can potentially affect the 
                expression of genes that regulate the stress response 
                across the life course.
            (10) According to a 2018 article in the North Carolina 
        Medical Journal entitled ``Adverse Childhood Experiences 
        (ACEs): An Important Element of a Comprehensive Approach to the 
        Opioid Crisis'', adverse childhood experiences (ACEs) are 
        traumatic or stressful experiences, including emotional, 
        physical, or sexual abuse, domestic violence, household 
        substance abuse, household mental illness, parental separation 
        or divorce, and the incarceration of a household family member.
            (11) According to a 2016 report in Development and 
        Psychopathology entitled ``Childhood Adversity and Epigenetic 
        Regulation of Glucocorticoid Signaling Genes: Associations in 
        Children and Adults''--
                    (A) children and adults are at risk of developing 
                psychiatric disorders and other medical conditions if 
                they have had an adverse childhood experience; and
                    (B) adults who have had numerous ACEs die nearly 20 
                years earlier, on average, than adults who have not had 
                numerous ACEs.

SEC. 3. SENSE OF CONGRESS.

    It is the sense of Congress that--
            (1) the United States Government should continue efforts to 
        reduce child mortality rates and increase attention on 
        prevention efforts and early childhood development programs;
            (2) investments in early childhood development ensure 
        healthy and well-developed future generations that contribute 
        to a country's stability, security and economic prosperity;
            (3) efforts to provide training and education on nurturing 
        care could result in improved early childhood development 
        outcomes and support healthy brain development; and
            (4) integration and cross-sector coordination of early 
        childhood development programs is critical to ensure the 
        efficiency, effectiveness, and continued implementation of such 
        programs.

SEC. 4. ASSISTANCE TO IMPROVE EARLY CHILDHOOD OUTCOMES GLOBALLY.

    (a) Authorization of Assistance.--Amounts authorized to be 
appropriated to carry out section 135 in chapter 1 of part 1 of the 
Foreign Assistance Act of 1961 (22 U.S.C. 2151 et seq.) for each of the 
fiscal years 2021 through 2025 are authorized to be made available to 
support early childhood development activities in conjunction with 
relevant, existing programming, such as water, sanitation and hygiene, 
maternal and child health, basic education, nutrition and child 
protection.
    (b) Assistance To Improve Early Childhood Outcomes Globally.--
Chapter 1 of part I of the Foreign Assistance Act of 1961 (22 U.S.C. 
2151 et seq.) is amended by adding at the end the following:

``SEC. 137. ASSISTANCE TO IMPROVE EARLY CHILDHOOD OUTCOMES GLOBALLY.

    ``(a) Definitions.--In this section:
            ``(1) Appropriate congressional committees.--The term 
        `appropriate congressional committees' means--
                    ``(A) the Committee on Appropriations of the 
                Senate;
                    ``(B) the Committee on Foreign Relations of the 
                Senate;
                    ``(C) the Committee on Appropriations of the House 
                of Representatives; and
                    ``(D) the Committee on Foreign Affairs of the House 
                of Representatives.
            ``(2) Early childhood development.--The term `early 
        childhood development' means the development and learning of a 
        child younger than 8 years of age, including physical, 
        cognitive, social, and emotional development and approaches to 
        learning that allow a child to reach his or her full 
        developmental potential.
            ``(3) Early childhood development program.--The term `early 
        childhood development program' means a program that ensures 
        that every child has the conditions for healthy growth, 
        nurturing family-based care, development and learning, and 
        protection from violence, exploitation, abuse, and neglect, 
        which may include--
                    ``(A) a health, clean water, sanitation, and 
                hygiene program that serves pregnant women, children 
                younger than 5 years of age, and the parents of such 
                children;
                    ``(B) a nutrition program, combined with 
                stimulating child development activity;
                    ``(C) age appropriate cognitive stimulation, 
                especially for newborns, infants, and toddlers, 
                including an early childhood intervention program for 
                children experiencing at-risk situations, developmental 
                delays, disabilities, and behavioral and mental health 
                conditions;
                    ``(D) an early learning (36 months and younger), 
                preschool, and basic education program for children 
                until they reach 8 years of age or complete primary 
                school; or
                    ``(E) a child protection program, with an emphasis 
                on the promotion of permanent, safe, and nurturing 
                families, rather than placement in residential care or 
                institutions, including for children with disabilities.
            ``(4) Federal departments and agencies.--The term `Federal 
        departments and agencies' means--
                    ``(A) the Department of State;
                    ``(B) the United States Agency for International 
                Development;
                    ``(C) the Department of the Treasury;
                    ``(D) the Department of Labor;
                    ``(E) the Department of Education;
                    ``(F) the Department of Agriculture;
                    ``(G) the Department of Defense;
                    ``(H) the Department of Health and Human Services, 
                including--
                            ``(i) the Centers for Disease Control and 
                        Prevention; and
                            ``(ii) the National Institutes of Health;
                    ``(I) the Millennium Challenge Corporation;
                    ``(J) the Peace Corps; and
                    ``(K) any other department or agency specified by 
                the President for the purposes of this section.
            ``(5) Residential care.--The term `residential care' means 
        care provided in any non-family-based group setting, including 
        orphanages, transit or interim care centers, children's homes, 
        children's villages or cottage complexes, group homes, and 
        boarding schools used primarily for care purposes as an 
        alternative to a children's home.
    ``(b) Statement of Policy.--It is the policy of the United States--
            ``(1) to support early childhood development in relevant 
        foreign assistance programs, including by integrating evidence-
        based, efficient, and effective interventions into relevant 
        strategies and programs, in coordination with partner 
        countries, other donors, international organizations, 
        international financial institutions, local and international 
        nongovernmental organizations, private sector partners, civil 
        society, and faith-based and community-based organizations; and
            ``(2) to encourage partner countries to lead early 
        childhood development initiatives that include incentives for 
        building local capacity for continued implementation and 
        measurable results, by--
                    ``(A) scaling up the most effective, evidence-
                based, national interventions, including for the most 
                vulnerable populations and children with disabilities 
                and developmental delays, with a focus on adaptation to 
                country resources, cultures, and languages;
                    ``(B) designing, implementing, monitoring, and 
                evaluating programs in a manner that enhances their 
                quality, transparency, equity, accountability, 
                efficiency and effectiveness in improving child and 
                family outcomes in partner countries; and
                    ``(C) utilizing and expanding innovative public-
                private financing mechanisms.
    ``(c) Implementation.--
            ``(1) In general.--Not later than 1 year after the date of 
        the enactment of this section, the Administrator of the United 
        States Agency for International Development, in coordination 
        with the Secretary of State, shall direct relevant Federal 
        departments and agencies--
                    ``(A) to incorporate, to the extent practical and 
                relevant, early childhood development into foreign 
                assistance programs to be carried out during the 
                following 5 fiscal years; and
                    ``(B) to promote inclusive early childhood 
                development in partner countries.
            ``(2) Elements.--In carrying out paragraph (1), the 
        Administrator, the Secretary, and the heads of other relevant 
        Federal departments and agencies as appropriate shall--
                    ``(A) build on the evidence and priorities outlined 
                in `Advancing Protection and Care for Children in 
                Adversity: A U.S. Government Strategy for International 
                Assistance 2019-2023', published in June 2019 (referred 
                to in this section as `APCCA');
                    ``(B) to the extent practicable, identify evidence-
                based strategic priorities, indicators, outcomes, and 
                targets, particularly emphasizing the most vulnerable 
                populations and children with disabilities and 
                developmental delays, to support inclusive early 
                childhood development;
                    ``(C) support the design, implementation, and 
                evaluation of pilot projects in partner countries, with 
                the goal of taking such projects to scale;
                    ``(D) support inclusive early childhood development 
                within all relevant sector strategies and public laws, 
                including--
                            ``(i) the Global Water Strategy required 
                        under section 136(j);
                            ``(ii) the whole-of-government strategy 
                        required under section 5 of the Global Food 
                        Security Act of 2016 (22 U.S.C. 9304 note);
                            ``(iii) the Basic Education Strategy set 
                        forth in section 105(c);
                            ``(iv) the U.S. Government Global Nutrition 
                        Coordination Plan, 2016-2021; and
                            ``(v) APCCA; and others as appropriate;
                    ``(E) improve coordination with foreign governments 
                and international and regional organizations with 
                respect to official country policies and plans to 
                improve early childhood development, maternal, newborn, 
                and child health and nutrition care, basic education, 
                water, sanitation and hygiene, and child protection 
                plans which promote nurturing, appropriate, protective, 
                and permanent family care, while reducing the 
                percentage of children living in residential care or on 
                the street; and
                    ``(F) consult with partner countries, other donors, 
                international organizations, international financial 
                institutions, local and international nongovernmental 
                organizations, private sector partners and faith-based 
                and community-based organizations, as appropriate.
    ``(d) Annual Report on the Implementation of the Strategy.--The 
Special Advisor for Children in Adversity shall include, in the annual 
report required under section 5 of the Assistance for Orphans and Other 
Vulnerable Children in Developing Countries Act of 2005 (22 U.S.C. 
2152g), which shall be submitted to the appropriate congressional 
committees and made publicly available, a description of--
            ``(1) the progress made toward integrating early childhood 
        development interventions into relevant strategies and 
        programs;
            ``(2) the efforts made by relevant Federal departments and 
        agencies to implement subsection (c), with a particular focus 
        on the activities described in such subsection;
            ``(3) the progress achieved during the reporting period 
        toward meeting the goals, objectives, benchmarks, described in 
        subsection (c); and
            ``(4) the progress achieved during the reporting period 
        toward meeting the goals, objectives, benchmarks, and 
        timeframes described in subsection (c) at the program level, 
        along with specific challenges or gaps that may require shifts 
        in targeting or financing in the following fiscal year.
    ``(e) Interagency Task Force.--The Special Advisor for Assistance 
to Orphans and Vulnerable Children should regularly convene an 
interagency task force, to coordinate--
            ``(1) intergovernmental and interagency monitoring, 
        evaluation, and reporting of the activities carried out 
        pursuant to this section;
            ``(2) early childhood development initiatives that include 
        children with a variety of needs and circumstances; and
            ``(3) United States Government early childhood development 
        programs, strategies, and partnerships across relevant Federal 
        departments and agencies.''.

SEC. 5. SPECIAL ADVISOR FOR ASSISTANCE TO ORPHANS AND VULNERABLE 
              CHILDREN.

    Section 135(e)(2) of the Foreign Assistance Act of 1961 (22 U.S.C. 
2152f(e)(2)) is amended--
            (1) by amending subparagraph (A) to read as follows:
                    ``(A) Coordinate assistance to orphans and other 
                vulnerable children among the relevant Executive branch 
                agencies and officials.''; and
            (2) in subparagraph (B), by striking ``the various offices, 
        bureaus, and field missions within the United States Agency for 
        International Development'' and inserting ``the relevant 
        Executive branch agencies and officials''.

SEC. 6. RULE OF CONSTRUCTION.

    Nothing in the amendments made by this Act may be construed to 
restrict or abrogate any other authorization for United States Agency 
for International Development activities or programs.

            Passed the House of Representatives September 22, 2020.

            Attest:

                                             CHERYL L. JOHNSON,

                                                                 Clerk.
```