II 

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. 

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled, 

3 SECTION 1. SHORT TITLE. 

4 This Act may be cited as the ‘‘Child Health Invest5 ment for Long-term Development (CHILD and Newborn) 

6 Act of 2006’’. 

7 SEC. 2. FINDINGS AND PURPOSES. 

8 (a) FINDINGS.—Congress finds the following: 

9 (1) Around the world, approximately 10.8 mil10 lion children under the age of five die each year, 


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1 more than 30,000 per day, almost all in the devel2 oping world. 

3 (2) Each year in the developing world, four mil4 lion newborns die in their first four weeks of life. 

5 (3) Sub-Saharan Africa, with only 10 percent of 

6 the world’s population, accounts for 43 percent of all 

7 deaths among children under the age of five. 

8 (4) Countries such as Afghanistan, Angola and 

9 Niger experience extreme levels of child mortality, 

10 with 25 percent of children dying before their fifth 

11 birthday. 

12 (5) For children under the age of five in the de13 veloping world, preventable or treatable diseases, 

14 such as measles, tetanus, diarrhea, pneumonia, and 

15 malaria, are the most common causes of death. 

16 (6) Throughout the developing world, the lack 

17 of basic health services, clean water, adequate sani18 tation, and proper nutrition contribute significantly 

19 to child mortality. 

20 (7) Hunger and malnutrition contribute to over 

21 five million child deaths annually. 

22 (8) The lack of low-cost antibiotics and anti23 malarial drugs contribute to three million child 

24 deaths each year. 


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1 (9) Lack of access to health services results in 

2 30 million children under the age of one year going 

3 without necessary immunizations. 

4 (10) Every year an estimated 250,000 to 

5 500,000 vitamin A-deficient children become blind, 

6 with one-half of such children dying within 12 

7 months of losing their sight. 

8 (11) Iron deficiency, affecting over 30 percent 

9 of the world’s population, causes premature birth, 

10 low birth weight, and infections, elevating the risk of 

11 death in children. 

12 (12) Two-thirds of deaths of children under five 

13 years of age, or 7.1 million children, including three 

14 million newborn deaths, could be prevented by low15 cost, low-tech health and nutritional interventions. 

16 (13) Exclusive breastfeeding—giving only 

17 breast milk for the first six months of life—could 

18 prevent an estimated 1.3 million newborn and infant 

19 deaths each year, primarily by protecting against di20 arrhea and pneumonia. 

21 (14) An additional two million lives could be 

22 saved annually by providing oral-rehydration therapy 

23 prepared with clean water. 

24 (15) During the 1990s, successful immuniza25 tion programs reduced polio by 99 percent, tetanus 


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1 deaths by 50 percent, and measles cases by 40 per2 cent. 

3 (16) Between 1998 and 2000, distribution of 

4 low-cost vitamin A supplements saved an estimated 

5 one million lives. 

6 (17) Expansion of clinical care of newborns and 

7 mothers, such as clean delivery by skilled attendants, 

8 emergency obstetric care, and neonatal resuscitation, 

9 can avert 50 percent of newborn deaths. 

10 (18) Keeping mothers healthy is essential for 

11 child survival because illness, complications, or ma12 ternal death during or following pregnancy increases 

13 the risk for death in newborns and infants. 

14 (19) Each year more than 525,000 women die 

15 from causes related to pregnancy and childbirth, 

16 with 99 percent of these deaths occurring in devel17 oping countries. 

18 (20) The lifetime risk of an African woman 

19 dying from a complication related to pregnancy or 

20 childbirth is 1 in 16, while the same risk for a 

21 woman in a developed country is 1 in 2,800. 

22 (21) Risk factors for maternal death in devel23 oping countries include early pregnancy and child24 birth, closely spaced births, infectious diseases, mal25 nutrition, and complications during childbirth. 


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1 (22) Birth spacing, access to preventive care, 

2 skilled birth attendants, and emergency obstetric 

3 care can help reduce maternal mortality. 

4 (23) The role of the United States in promoting 

5 child survival and maternal health over the past 

6 three decades has resulted in millions of lives being 

7 saved around the world. 

8 (24) In 2000, the United States joined 188 

9 other countries in supporting eight Millennium De10 velopment Goals designed to achieve ‘‘a more peace11 ful, prosperous and just world’’. 

12 (25) Two of the Millennium Development Goals 

13 call for a reduction in the mortality rate of children 

14 under the age of five by two-thirds and a reduction 

15 in maternal deaths by three-quarters by 2015. 

16 (26) On September 14, 2005, President George 

17 W. Bush stated before the leaders of the world: ‘‘To 

18 spread a vision of hope, the United States is deter19 mined to help nations that are struggling with pov20 erty. We are committed to the Millennium Develop21 ment Goals.’’. 

22 (b) PURPOSES.—The purposes of this Act are to— 

23 (1) authorize assistance to improve the health 

24 of newborns, children, and mothers in developing 


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1 countries, including by strengthening the capacity of 

2 health systems and health workers; 

3 (2) develop and implement a strategy to im4 prove the health of newborns, children, and mothers, 

5 including reducing child and maternal mortality, in 

6 developing countries; 

7 (3) to establish a task force to assess, monitor, 

8 and evaluate the progress and contributions of rel9 evant departments and agencies of the Government 

10 of the United States in achieving the United Nations 

11 Millennium Development Goals by 2015 for reducing 

12 the mortality of children under the age of five by 

13 two-thirds and reducing maternal mortality by three14 quarters in developing countries. 

15 SEC. 3. ASSISTANCE TO IMPROVE THE HEALTH OF 

16 NEWBORNS, CHILDREN, AND MOTHERS IN 

17 DEVELOPING COUNTRIES. 

18 (a) IN GENERAL.—Chapter 1 of part I of the Foreign 

19 Assistance Act of 1961 (22 U.S.C. 2151 et seq.) is amend20 ed— 

21 (1) in section 104(c)— 

22 (A) by striking paragraphs (2) and (3); 

23 and 

24 (B) by redesignating paragraph (4) as 

25 paragraph (2); 


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1 (2) by redesignating sections 104A, 104B, and 

2 104C as sections 104B, 104C, and 104D, respec3 tively; and 

4 (3) by inserting after section 104 the following 

5 new section: 

6 ‘‘SEC. 104A. ASSISTANCE TO IMPROVE THE HEALTH OF 

7 NEWBORNS, CHILDREN, AND MOTHERS. 

8 ‘‘(a) AUTHORIZATION.—Consistent with section 

9 104(c), the President is authorized to furnish assistance, 

10 on such terms and conditions as the President may deter11 mine, to improve the health of newborns, children, and 

12 mothers in developing countries. 

13 ‘‘(b) ACTIVITIES SUPPORTED.—Assistance provided 

14 under subsection (b) shall, to the maximum extent prac15 ticable, be used to carry out the following activities: 

16 ‘‘(1) Activities to strengthen the capacity of 

17 health systems in developing countries, including 

18 training for clinicians, nurses, technicians, sanitation 

19 and public health workers, community-based health 

20 workers, midwives and birth attendants, peer edu21 cators, and private sector enterprises. 

22 ‘‘(2) Activities to provide health care access to 

23 underserved and marginalized populations. 

24 ‘‘(3) Activities to ensure the supply, logistical 

25 support, and distribution of essential drugs, vacVerDate Aug 31 2005 21:58 May 10, 2006 Jkt 049200 PO 00000 Frm 00007 Fmt 6652 Sfmt 6201 E:\BILLS\S2765.IS S2765

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1 cines, commodities, and equipment to regional, dis2 trict, and local levels. 

3 ‘‘(4) Activities to educate underserved and 

4 marginalized populations to seek health care when 

5 appropriate, including clinical and community-based 

6 activities. 

7 ‘‘(5) Activities to integrate and coordinate as8 sistance provided under this section with existing 

9 health programs for— 

10 ‘‘(A) the prevention of the transmission of 

11 HIV from mother-to-child and other HIV/AIDS 

12 counseling, care, and treatment activities; 

13 ‘‘(B) malaria; 

14 ‘‘(C) tuberculosis; and 

15 ‘‘(D) child spacing. 

16 ‘‘(6) Activities to expand access to safe water 

17 and sanitation. 

18 ‘‘(7) Activities to expand the use of and tech19 nical support for appropriate technology to reduce 

20 acute respiratory infection from firewood smoke in21 halation. 

22 ‘‘(c) GUIDELINES.—To the maximum extent prac23 ticable, programs, projects, and activities carried out using 

24 assistance provided under this section shall be— 


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1 ‘‘(1) carried out through private and voluntary 

2 organizations, as well as faith-based organizations, 

3 giving priority to organizations that demonstrate ef4 fectiveness and commitment to improving the health 

5 of newborns, children, and mothers; 

6 ‘‘(2) carried out with input by host countries, 

7 including civil society and local communities, as well 

8 as other donors and multilateral organizations; 

9 ‘‘(3) carried out with input by beneficiaries and 

10 other directly affected populations, especially women 

11 and marginalized communities; and 

12 ‘‘(4) designed to build the capacity of host 

13 country governments and civil society organizations. 

14 ‘‘(d) ANNUAL REPORT.—Not later than January 31 

15 of each year, the President shall transmit to Congress a 

16 report on the implementation of this section for the prior 

17 fiscal year. 

18 ‘‘(e) DEFINITIONS.—In this section: 

19 ‘‘(1) AIDS.—The term ‘AIDS’ has the meaning 

20 given the term in section 104B(g)(1) of this Act. 

21 ‘‘(2) HIV.—The term ‘HIV’ has the meaning 

22 given the term in section 104B(g)(2) of this Act. 

23 ‘‘(3) HIV/AIDS.—The term ‘HIV/AIDS’ has 

24 the meaning given the term in section 104B(g)(3) of 

25 this Act.’’. 


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1 (b) CONFORMING AMENDMENTS.—The Foreign As2 sistance Act of 1961 (22 U.S.C. 2151 et seq.) is amend3 ed— 

4 (1) in section 104(c)(2) (as redesignated by 

5 subsection (a)(1)(B) of this section), by striking 

6 ‘‘and 104C’’ and inserting ‘‘104C, and 104D’’; 

7 (2) in section 104B (as redesignated by sub8 section (a)(2) of this section)— 

9 (A) in subsection (c)(1), by inserting ‘‘and 

10 section 104A’’ after ‘‘section 104(c)’’; 

11 (B) in subsection (e)(2), by striking ‘‘sec12 tion 104B, and section 104C’’ and inserting 

13 ‘‘section 104C, and section 104D’’; and 

14 (C) in subsection (f), by striking ‘‘section 

15 104(c), this section, section 104B, and section 

16 104C’’ and inserting ‘‘section 104(c), section 

17 104A, this section, section 104C, and section 

18 104D’’; 

19 (3) in subsection (c) of section 104C (as redes20 ignated by subsection (a)(2) of this section), by in21 serting ‘‘and section 104A’’ after ‘‘section 104(c)’’; 

22 (4) in subsection (c) of section 104D (as redes23 ignated by subsection (a)(2) of this section), by in24 serting ‘‘and section 104A’’ after ‘‘section 104(c)’’; 

25 and 


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1 (5) in the first sentence of section 119(c), by 

2 striking ‘‘section 104(c)(2), relating to Child Sur3 vival Fund’’ and inserting ‘‘section 104A’’. 

4 SEC. 4. DEVELOPMENT OF STRATEGY TO IMPROVE THE 

5 HEALTH OF NEWBORNS, CHILDREN, AND 

6 MOTHERS IN DEVELOPING COUNTRIES. 

7 (a) DEVELOPMENT OF STRATEGY.—The President 

8 shall develop a comprehensive strategy to improve the 

9 health of newborns, children, and mothers, including re10 ducing newborn, child, and maternal mortality, in devel11 oping countries. 

12 (b) COMPONENTS.—The strategy developed pursuant 

13 to subsection (a) shall include the following: 

14 (1) Programmatic areas and interventions pro15 viding maximum health benefits to populations at 

16 risk as well as maximum reduction in mortality, in17 cluding— 

18 (A) costs and benefits of programs and 

19 interventions; and 

20 (B) investments needed in identified pro21 grams and interventions to achieve the greatest 

22 results. 

23 (2) An identification of countries with priority 

24 needs for the five-year period beginning on the date 

25 of the enactment of this Act based on— 


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1 (A) the neonatal mortality rate; 

2 (B) the mortality rate of children under 

3 the age of five; 

4 (C) the maternal mortality rate; 

5 (D) the percentage of women and children 

6 with limited or no access to basic health care; 

7 and 

8 (E) additional criteria for evaluation such 

9 as— 

10 (i) the percentage of one-year old chil11 dren who are fully immunized; 

12 (ii) the percentage of children under 

13 the age of five who sleep under insecticide14 treated bed nets; 

15 (iii) the percentage of children under 

16 the age of five with fever treated with anti17 malarial drugs; 

18 (iv) the percentage of children under 

19 the age of five who are covered by vitamin 

20 A supplementation; 

21 (v) the percentage of children under 

22 the age of five with diarrhea who are re23 ceiving oral-rehydration therapy and con24 tinued feeding; 


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1 (vi) the percentage of children under 

2 the age of five with pneumonia who are re3 ceiving appropriate care; 

4 (vii) the percentage of the population 

5 with access to improved sanitation facili6 ties; 

7 (viii) the percentage of the population 

8 with access to safe drinking water; 

9 (ix) the percentage of children under 

10 the age of five who are underweight for 

11 their age; 

12 (x) the percentage of births attended 

13 by skilled health care personnel; 

14 (xi) the percentage of women with ac15 cess to emergency obstetric care; 

16 (xii) the potential for implementing 

17 newborn, child, and maternal health inter18 ventions at scale; and 

19 (xiii) the demonstrated commitment of 

20 countries to newborn, child, and maternal 

21 health. 

22 (3) A description of how United States assist23 ance complements and leverages efforts by other do24 nors, as well as builds capacity and self-sufficiency 

25 among recipient countries. 


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1 (4) An expansion of the Child Survival and 

2 Health Grants Program of the United States Agency 

3 for International Development to provide additional 

4 support programs and interventions determined to 

5 be efficacious and cost-effective in improving health 

6 and reducing mortality. 

7 (5) Enhanced coordination among relevant de8 partments and agencies of the Government of the 

9 United States engaged in activities to improve the 

10 health of newborns, children, and mothers in devel11 oping countries. 

12 (c) REPORT.—Not later than 180 days after the date 

13 of the enactment of this Act, the President shall transmit 

14 to Congress a report that contains the strategy described 

15 in this section. 

16 SEC. 5. INTERAGENCY TASK FORCE ON CHILD SURVIVAL 

17 AND MATERNAL HEALTH IN DEVELOPING 

18 COUNTRIES. 

19 (a) ESTABLISHMENT.—There is established a task 

20 force to be known as the Interagency Task Force on Child 

21 Survival and Maternal Health in Developing Countries (in 

22 this section referred to as the ‘‘Task Force’’). 

23 (b) DUTIES.— 

24 (1) IN GENERAL.—The Task Force shall assess, 

25 monitor, and evaluate the progress and contributions 


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1 of relevant departments and agencies of the Govern2 ment of the United States in achieving the Millen3 nium Development Goals by 2015 for reducing the 

4 mortality of children under the age of five by two5 thirds and reducing maternal mortality by three6 quarters in developing countries, including by— 

7 (A) identifying and evaluating programs 

8 and interventions that directly or indirectly con9 tribute to the reduction of child and maternal 

10 mortality rates; 

11 (B) assessing effectiveness of programs, 

12 interventions, and strategies toward achieving 

13 the maximum reduction of child and maternal 

14 mortality rates; 

15 (C) assessing the level of coordination 

16 among relevant departments and agencies of 

17 the Government of the United States, the inter18 national community, international organiza19 tions, faith-based organizations, academic insti20 tutions, and the private sector; 

21 (D) assessing the contributions made by 

22 United States-funded programs toward achiev23 ing the Millennium Development Goals; 


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1 (E) identifying the bilateral efforts of other 

2 nations and multilateral efforts toward achiev3 ing the Millennium Development Goals; and 

4 (F) preparing the annual report required 

5 by subsection (f). 

6 (2) CONSULTATION.—To the maximum extent 

7 practicable, the Task Force shall consult with indi8 viduals with expertise in the matters to be consid9 ered by the Task Force who are not officers or em10 ployees of the Government of the United States, in11 cluding representatives of United States-based non12 governmental organizations (including faith-based 

13 organizations and private foundations), academic in14 stitutions, private corporations, the United Nations 

15 Children’s Fund (UNICEF), and the World Bank. 

16 (c) MEMBERSHIP.— 

17 (1) NUMBER AND APPOINTMENT.—The Task 

18 Force shall be composed of the following members: 

19 (A) The Administrator of the United 

20 States Agency for International Development. 

21 (B) The Assistant Secretary of State for 

22 Population, Refugees and Migration. 

23 (C) The Coordinator of United States Gov24 ernment Activities to Combat HIV/AIDS Glob25 ally. 


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1 (D) The Director of the Office of Global 

2 Health Affairs of the Department of Health 

3 and Human Services. 

4 (E) The Under Secretary for Food, Nutri5 tion and Consumer Services of the Department 

6 of Agriculture. 

7 (F) The Chief Executive Officer of the Mil8 lennium Challenge Corporation. 

9 (G) The Director of the Peace Corps. 

10 (H) Other officials of relevant departments 

11 and agencies of the Federal Government who 

12 shall be appointed by the President. 

13 (2) CHAIRPERSON.—The Administrator of the 

14 United States Agency for International Development 

15 shall serve as chairperson of the Task Force. 

16 (d) MEETINGS.—The Task Force shall meet on a reg17 ular basis, not less often than quarterly, on a schedule 

18 to be agreed upon by the members of the Task Force, and 

19 starting not later than 90 days after the date of the enact20 ment of this Act. 

21 (e) DEFINITION.—In this subsection, the term ‘‘Mil22 lennium Development Goals’’ means the key development 

23 objectives described in the United Nations Millennium 

24 Declaration, as contained in United Nations General As25 sembly Resolution 55/2 (September 2000). 


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1 (f) REPORT.—Not later than 120 days after the date 

2 of the enactment of this Act, and not later than April 30 

3 of each year thereafter, the Task Force shall submit to 

4 Congress and the President a report on the implementa5 tion of this section. 

6 SEC. 6. AUTHORIZATION OF APPROPRIATIONS. 

7 (a) IN GENERAL.—There are authorized to be appro8 priated to carry out this Act, and the amendments made 

9 by this Act, $660,000,000 for fiscal year 2007 and 

10 $1,200,000,000 for each of the fiscal years 2008 through 

11 2011. 

12 (b) AVAILABILITY OF FUNDS.—Amounts appro13 priated pursuant to the authorization of appropriations 

14 under subsection (a) are authorized to remain available 

15 until expended. 

Æ 


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