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[Congressional Bills 110th Congress]
[From the U.S. Government Publishing Office]
[H.R. 2266 Introduced in House (IH)]

110th CONGRESS
  1st Session
                                H. R. 2266

To provide assistance to improve the health of newborns, children, and 
        mothers in developing countries, and for other purposes.

_______________________________________________________________________

                    IN THE HOUSE OF REPRESENTATIVES

                              May 10, 2007

   Ms. McCollum of Minnesota (for herself, Mr. Shays, Mr. Payne, Mr. 
 Reichert, Mr. Blumenauer, Mr. Crowley, Mr. Ellison, Mr. Grijalva, Mr. 
  Honda, Ms. Jackson-Lee of Texas, Mr. Jefferson, Mr. McDermott, Mr. 
     McGovern, Mr. Olver, Mr. Snyder, Ms. Watson, and Ms. Woolsey) 
 introduced the following bill; which was referred to the Committee on 
                            Foreign Affairs

_______________________________________________________________________

                                 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 ``United States Commitment to Global 
Child Survival Act of 2007''.

SEC. 2. FINDINGS AND PURPOSES.

    (a) Findings.--Congress finds the following:
            (1) The significant commitment of the United States to 
        reducing child mortality in the developing world contributed to 
        a 50 percent reduction in the mortality of children under the 
        age of 5 between 1960 and 1990.
            (2) The United States Agency for International 
        Development's support for child survival interventions and 
        technologies during the 1970s and 1980s saves the lives of 
        millions of children each year.
            (3) Since 1990 significant progress in child survival has 
        been made, including substantial reductions in child mortality 
        in Egypt (68 percent), Nepal (49 percent), and Malawi (43 
        percent).
            (4) While United States investments in child survival has 
        contributed to a major decline in the rate of child mortality, 
        10.1 million children under the age of 5 die each year, over 
        28,000 children per day, from easily preventable and treatable 
        causes.
            (5) Four million newborns die in the first 4 weeks of life, 
        which accounts for 38 percent of all deaths of children under 
        the age of 5.
            (6) Ninety percent of deaths of children under the age of 5 
        occur in just 42 countries.
            (7) According to the Lancet, 67 percent of neonatal deaths 
        take place in just 10 countries: India, China, Pakistan, 
        Nigeria, Bangladesh, Ethiopia, the Democratic Republic of the 
        Congo, Indonesia, Afghanistan, and the United Republic of 
        Tanzania.
            (8) According to the Lancet, maternal health is an 
        important determinant of neonatal survival with maternal death 
        increasing death rates for newborns to as high as 100 percent 
        in poor countries.
            (9) Approximately 525,000 women die every year in the 
        developing world from causes related to pregnancy and 
        childbirth.
            (10) Poverty is the root cause of many maternal and 
        neonatal deaths, either because it increases the prevalence of 
        risk factors or because it reduces access to care.
            (11) Risk factors for maternal death in developing 
        countries include pregnancy and childbirth at an early age, 
        closely-spaced births, infectious diseases, malnutrition, and 
        complications during childbirth.
            (12) Skilled birth attendants, access to preventive care, 
        and child spacing can reduce maternal mortality and increase 
        child survival rates.
            (13) A package of 20 affordable interventions, including 
        skilled care at birth, emergency obstetric care, breastfeeding, 
        vaccinations, antibiotics, and micro-nutrients, could save 6 
        million children per year at a cost of only $25 per child or 
        $1.62 per person in 60 priority countries.
            (14) Millions of children's lives can be saved by high-
        impact, low-cost, feasible interventions like oral rehydration 
        therapy (ORT) for diarrhea ($0.06 per treatment), antibiotics 
        to treat respiratory infections ($0.25 per treatment), and 
        anti-malaria tablets ($0.12 per treatment).
            (15) Three million children die each year due to lack of 
        access to low-cost antibiotics and anti-malarial drugs.
            (16) Lack of access to health services results in 30 
        million children under the age of 1 year going without 
        necessary immunizations and 1.7 million children dying from 
        diseases in which vaccines are readily available.
            (17) During the 1990s, successful immunization programs 
        reduced polio by 99 percent, tetanus deaths by 50 percent, and 
        measles cases by 40 percent.
            (18) Between 1999 and 2004, distribution of low-cost 
        vitamin A supplements saved an estimated 2.3 million lives, yet 
        the unmet need for vitamin A supplements results in an 
        estimated 250,000 to 500,000 children becoming blind each year, 
        with 70 percent of such children dying within 12 months of 
        losing their sight.
            (19) Exclusive breastfeeding--giving only breast milk for 
        the first 6 months of life--could prevent an estimated 1.3 
        million newborn and infant deaths each year, primarily by 
        protecting against diarrhea and pneumonia.
            (20) Two million lives could be saved annually by providing 
        oral-rehydration therapy prepared with clean water.
            (21) 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.
            (22) The United Nations Children's Fund (UNICEF), with 
        support from the World Health Organization, the World Bank, and 
        the African Union, has successfully demonstrated the 
        accelerated child survival and development program in Senegal, 
        Mali, Benin, and Ghana, reducing mortality of children under 
        the age of 5 by 20 percent in targeted areas using low-cost, 
        high-impact interventions.
            (23) In 2000, the United States joined 188 other countries 
        in supporting 8 United Nations Millennium Development Goals, 
        including goals to reduce the mortality rate of children under 
        the age of 5 by two-thirds and reduce maternal deaths by three-
        quarters by 2015.
            (24) 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 reduce mortality and improve 
        the health of newborns, children, and mothers in developing 
        countries, including strengthening the capacity of health 
        systems and health workers;
            (2) develop and implement a strategy to reduce mortality 
        and improve the health of newborns, children, and mothers in 
        developing countries; and
            (3) 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 5 by two-
        thirds and reducing maternal mortality by three-quarters in 
        developing countries.

SEC. 3. ASSISTANCE TO REDUCE MORTALITY AND 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--
            (1) in section 104(c)--
                    (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 REDUCE MORTALITY AND 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 reduce mortality and improve the health 
of newborns, children, and mothers in developing countries.
    ``(b) Activities Supported.--Assistance provided under subsection 
(a) shall, to the maximum extent practicable, be used to carry out the 
following:
            ``(1) Activities to improve newborn care and treatment.
            ``(2) Activities to treat childhood illness, including 
        increasing access to and utilization of appropriate treatment 
        for diarrhea, pneumonia, and other life-threatening childhood 
        illnesses.
            ``(3) Activities to improve child and maternal nutrition, 
        including the delivery of iron, zinc, vitamin A, iodine, and 
        other key micronutrients and the promotion of breastfeeding.
            ``(4) Activities to strengthen the delivery of immunization 
        services, including efforts to eliminate polio.
            ``(5) Activities to improve birth preparedness and 
        maternity services.
            ``(6) Activities to improve the recognition and treatment 
        of obstetric complications and disabilities.
            ``(7) Activities to improve household-level behavior 
        related to safe water, hygiene, exposure to indoor smoke, and 
        environmental toxins such as lead.
            ``(8) Activities to improve capacity for health governance, 
        finance and workforce, including support for training 
        clinicians, nurses, technicians, sanitation and public health 
        workers, community-based health workers, midwives, birth 
        attendants, peer educators, volunteers, and private sector 
        enterprises.
            ``(9) Activities to address antimicrobial resistance in 
        child and maternal health.
            ``(10) Activities to establish and support host country 
        institutions' management information systems and the 
        development and use of tools and models to collect, analyze, 
        and disseminate information related to newborn, child, and 
        maternal health.
            ``(11) Activities to develop and conduct needs assessments, 
        baseline studies, targeted evaluations, or other information-
        gathering efforts for the design, monitoring, and evaluation of 
        newborn, child, and maternal health efforts.
            ``(12) 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;
                    ``(B) malaria;
                    ``(C) tuberculosis; and
                    ``(D) child spacing.
    ``(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, including faith-based organizations, and 
        relevant international and multilateral organizations, 
        including the GAVI Alliance (formerly known as the Global 
        Alliance for Vaccines and Immunization) and the United Nations 
        Children's Fund (UNICEF), 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)'';
            (5) in the first sentence of section 119(c), by striking 
        ``section 104(c)(2), relating to Child Survival Fund'' and 
        inserting ``section 104A''; and
            (6) in section 135(b)--
                    (A) in paragraph (1), by striking ``section 
                104A(g)(1)'' and inserting ``section 104B(g)(1)''; and
                    (B) in paragraph (3), by striking ``section 
                104A(g)(3)'' and inserting ``section 104B(g)(3)''.

SEC. 4. STRATEGY TO REDUCE MORTALITY AND IMPROVE THE HEALTH OF 
              NEWBORNS, CHILDREN, AND MOTHERS IN DEVELOPING COUNTRIES.

    (a) Strategy Required.--The President shall develop and implement a 
comprehensive United States Government strategy to reduce mortality and 
improve the health of newborns, children, and mothers in developing 
countries.
    (b) Components.--The comprehensive United States Government 
strategy developed pursuant to subsection (a) shall include the 
following:
            (1) An identification of not less than 60 countries with 
        priority needs for the 5-year period beginning on the date of 
        the enactment of this Act based on--
                    (A) the number and rate of neonatal deaths;
                    (B) the number and rate of child deaths; and
                    (C) the number and rate of maternal deaths.
            (2) For each country identified in paragraph (1)--
                    (A) an assessment of the most common causes of 
                newborn, child, and maternal mortality;
                    (B) a description of the programmatic areas and 
                interventions providing maximum health benefits to 
                populations at risk as well as maximum reduction in 
                mortality;
                    (C) an assessment of the investments needed in 
                identified programs and interventions to achieve the 
                greatest results;
                    (D) 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; and
                    (E) a description of goals and objectives for 
                improving maternal, newborn, and child health, 
                including, to the extent feasible, objective and 
                quantifiable indicators.
            (3) An expansion of the Child Survival and Health Grants 
        Program of the United States Agency for International 
        Development, at a minimum proportionate to any increase in 
        child and maternal health assistance, to provide additional 
        support programs and interventions determined to be efficacious 
        and cost-effective in improving health and reducing mortality.
            (4) Enhanced coordination among relevant departments and 
        agencies of the United States Government engaged in activities 
        to improve the health and well-being of newborns, children, and 
        mothers in developing countries.
            (5) A description of the measured or estimated impact on 
        child morbidity and mortality of each project or program 
        carried out.
    (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'').
    (b) Duties.--
            (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 United Nations Millennium Development Goals by 
        2015 for reducing the mortality of children under the age of 5 
        by two-thirds (Millennium Development Goal 4) and reducing 
        maternal mortality by three-quarters (Millennium Development 
        Goal 5) in developing countries, including by--
                    (A) identifying and evaluating programs and 
                interventions that directly or indirectly contribute to 
                the reduction of newborn, child, and maternal mortality 
                rates;
                    (B) assessing effectiveness of programs, 
                interventions, and strategies toward achieving the 
                maximum reduction of newborn, 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 4 and 5;
                    (E) identifying the bilateral efforts of other 
                nations and multilateral efforts toward achieving the 
                Millennium Development Goals 4 and 5; 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.
    (c) Membership.--
            (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.
                    (I) Two ex-officio members appointed by the Speaker 
                of the House of Representatives in consultation with 
                the minority leader of the House of Representatives.
                    (J) Two ex-officio members appointed by the 
                majority leader of the Senate in consultation with the 
                minority leader of the Senate.
            (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, $600,000,000 for 
fiscal year 2008, $900,000,000 for fiscal year 2009, $1,200,000,000 for 
fiscal year 2010, and $1,600,000,00 for each of the fiscal years 2011 
and 2012.
    (b) Availability of Funds.--Amounts appropriated pursuant to the 
authorization of appropriations under subsection (a) are authorized to 
remain available until expended.
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