I 

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. 

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 ‘‘United States Commit5 ment to Global Child Survival Act of 2007’’. 

6 SEC. 2. FINDINGS AND PURPOSES. 

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


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1 (1) The significant commitment of the United 

2 States to reducing child mortality in the developing 

3 world contributed to a 50 percent reduction in the 

4 mortality of children under the age of 5 between 

5 1960 and 1990. 

6 (2) The United States Agency for International 

7 Development’s support for child survival interven8 tions and technologies during the 1970s and 1980s 

9 saves the lives of millions of children each year. 

10 (3) Since 1990 significant progress in child sur11 vival has been made, including substantial reduc12 tions in child mortality in Egypt (68 percent), Nepal 

13 (49 percent), and Malawi (43 percent). 

14 (4) While United States investments in child 

15 survival has contributed to a major decline in the 

16 rate of child mortality, 10.1 million children under 

17 the age of 5 die each year, over 28,000 children per 

18 day, from easily preventable and treatable causes. 

19 (5) Four million newborns die in the first 4 

20 weeks of life, which accounts for 38 percent of all 

21 deaths of children under the age of 5. 

22 (6) Ninety percent of deaths of children under 

23 the age of 5 occur in just 42 countries. 

24 (7) According to the Lancet, 67 percent of neo25 natal deaths take place in just 10 countries: India, 


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1 China, Pakistan, Nigeria, Bangladesh, Ethiopia, the 

2 Democratic Republic of the Congo, Indonesia, Af3 ghanistan, and the United Republic of Tanzania. 

4 (8) According to the Lancet, maternal health is 

5 an important determinant of neonatal survival with 

6 maternal death increasing death rates for newborns 

7 to as high as 100 percent in poor countries. 

8 (9) Approximately 525,000 women die every 

9 year in the developing world from causes related to 

10 pregnancy and childbirth. 

11 (10) Poverty is the root cause of many mater12 nal and neonatal deaths, either because it increases 

13 the prevalence of risk factors or because it reduces 

14 access to care. 

15 (11) Risk factors for maternal death in devel16 oping countries include pregnancy and childbirth at 

17 an early age, closely-spaced births, infectious dis18 eases, malnutrition, and complications during child19 birth. 

20 (12) Skilled birth attendants, access to preven21 tive care, and child spacing can reduce maternal 

22 mortality and increase child survival rates. 

23 (13) A package of 20 affordable interventions, 

24 including skilled care at birth, emergency obstetric 

25 care, breastfeeding, vaccinations, antibiotics, and 


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1 micro-nutrients, could save 6 million children per 

2 year at a cost of only $25 per child or $1.62 per 

3 person in 60 priority countries. 

4 (14) Millions of children’s lives can be saved by 

5 high-impact, low-cost, feasible interventions like oral 

6 rehydration therapy (ORT) for diarrhea ($0.06 per 

7 treatment), antibiotics to treat respiratory infections 

8 ($0.25 per treatment), and anti-malaria tablets 

9 ($0.12 per treatment). 

10 (15) Three million children die each year due to 

11 lack of access to low-cost antibiotics and anti-malar12 ial drugs. 

13 (16) Lack of access to health services results in 

14 30 million children under the age of 1 year going 

15 without necessary immunizations and 1.7 million 

16 children dying from diseases in which vaccines are 

17 readily available. 

18 (17) During the 1990s, successful immuniza19 tion programs reduced polio by 99 percent, tetanus 

20 deaths by 50 percent, and measles cases by 40 per21 cent. 

22 (18) Between 1999 and 2004, distribution of 

23 low-cost vitamin A supplements saved an estimated 

24 2.3 million lives, yet the unmet need for vitamin A 

25 supplements results in an estimated 250,000 to 


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1 500,000 children becoming blind each year, with 70 

2 percent of such children dying within 12 months of 

3 losing their sight. 

4 (19) Exclusive breastfeeding—giving only 

5 breast milk for the first 6 months of life—could pre6 vent an estimated 1.3 million newborn and infant 

7 deaths each year, primarily by protecting against di8 arrhea and pneumonia. 

9 (20) Two million lives could be saved annually 

10 by providing oral-rehydration therapy prepared with 

11 clean water. 

12 (21) Expansion of clinical care of newborns and 

13 mothers, such as clean delivery by skilled attendants, 

14 emergency obstetric care, and neonatal resuscitation, 

15 can avert 50 percent of newborn deaths. 

16 (22) The United Nations Children’s Fund 

17 (UNICEF), with support from the World Health Or18 ganization, the World Bank, and the African Union, 

19 has successfully demonstrated the accelerated child 

20 survival and development program in Senegal, Mali, 

21 Benin, and Ghana, reducing mortality of children 

22 under the age of 5 by 20 percent in targeted areas 

23 using low-cost, high-impact interventions. 

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

25 other countries in supporting 8 United Nations MilVerDate Aug 31 2005 20:21 May 11, 2007 Jkt 059200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6201 E:\BILLS\H2266.IH H2266

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1 lennium Development Goals, including goals to re2 duce the mortality rate of children under the age of 

3 5 by two-thirds and reduce maternal deaths by 

4 three-quarters by 2015. 

5 (24) On September 14, 2005, President George 

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

7 spread a vision of hope, the United States is deter8 mined to help nations that are struggling with pov9 erty. We are committed to the Millennium Develop10 ment Goals.’’. 

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

12 (1) authorize assistance to reduce mortality and 

13 improve the health of newborns, children, and moth14 ers in developing countries, including strengthening 

15 the capacity of health systems and health workers; 

16 (2) develop and implement a strategy to reduce 

17 mortality and improve the health of newborns, chil18 dren, and mothers in developing countries; and 

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

20 and evaluate the progress and contributions of rel21 evant departments and agencies of the Government 

22 of the United States in achieving the United Nations 

23 Millennium Development Goals by 2015 for reducing 

24 the mortality of children under the age of 5 by twoVerDate Aug 31 2005 20:21 May 11, 2007 Jkt 059200 PO 00000 Frm 00006 Fmt 6652 Sfmt 6201 E:\BILLS\H2266.IH H2266

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1 thirds and reducing maternal mortality by three2 quarters in developing countries. 

3 SEC. 3. ASSISTANCE TO REDUCE MORTALITY AND IMPROVE 

4 THE HEALTH OF NEWBORNS, CHILDREN, AND 

5 MOTHERS IN DEVELOPING COUNTRIES. 

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

7 Assistance Act of 1961 (22 U.S.C. 2151 et seq.) is amend8 ed— 

9 (1) in section 104(c)— 

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

11 and 

12 (B) by redesignating paragraph (4) as 

13 paragraph (2); 

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

15 104C as sections 104B, 104C, and 104D, respec16 tively; and 

17 (3) by inserting after section 104 the following 

18 new section: 

19 ‘‘SEC. 104A. ASSISTANCE TO REDUCE MORTALITY AND IM20 PROVE THE HEALTH OF NEWBORNS, CHIL21 DREN, AND MOTHERS. 

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

23 104(c), the President is authorized to furnish assistance, 

24 on such terms and conditions as the President may deterVerDate Aug 31 2005 20:21 May 11, 2007 Jkt 059200 PO 00000 Frm 00007 Fmt 6652 Sfmt 6201 E:\BILLS\H2266.IH H2266

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1 mine, to reduce mortality and improve the health of 

2 newborns, children, and mothers in developing countries. 

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

4 under subsection (a) shall, to the maximum extent prac5 ticable, be used to carry out the following: 

6 ‘‘(1) Activities to improve newborn care and 

7 treatment. 

8 ‘‘(2) Activities to treat childhood illness, includ9 ing increasing access to and utilization of appro10 priate treatment for diarrhea, pneumonia, and other 

11 life-threatening childhood illnesses. 

12 ‘‘(3) Activities to improve child and maternal 

13 nutrition, including the delivery of iron, zinc, vita14 min A, iodine, and other key micronutrients and the 

15 promotion of breastfeeding. 

16 ‘‘(4) Activities to strengthen the delivery of im17 munization services, including efforts to eliminate 

18 polio. 

19 ‘‘(5) Activities to improve birth preparedness 

20 and maternity services. 

21 ‘‘(6) Activities to improve the recognition and 

22 treatment of obstetric complications and disabilities. 

23 ‘‘(7) Activities to improve household-level be24 havior related to safe water, hygiene, exposure to in25 door smoke, and environmental toxins such as lead. 


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1 ‘‘(8) Activities to improve capacity for health 

2 governance, finance and workforce, including sup3 port for training clinicians, nurses, technicians, sani4 tation and public health workers, community-based 

5 health workers, midwives, birth attendants, peer 

6 educators, volunteers, and private sector enterprises. 

7 ‘‘(9) Activities to address antimicrobial resist8 ance in child and maternal health. 

9 ‘‘(10) Activities to establish and support host 

10 country institutions’ management information sys11 tems and the development and use of tools and mod12 els to collect, analyze, and disseminate information 

13 related to newborn, child, and maternal health. 

14 ‘‘(11) Activities to develop and conduct needs 

15 assessments, baseline studies, targeted evaluations, 

16 or other information-gathering efforts for the design, 

17 monitoring, and evaluation of newborn, child, and 

18 maternal health efforts. 

19 ‘‘(12) Activities to integrate and coordinate as20 sistance provided under this section with existing 

21 health programs for— 

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

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

24 counseling, care, and treatment activities; 

25 ‘‘(B) malaria; 


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1 ‘‘(C) tuberculosis; and 

2 ‘‘(D) child spacing. 

3 ‘‘(c) GUIDELINES.—To the maximum extent prac4 ticable, programs, projects, and activities carried out using 

5 assistance provided under this section shall be— 

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

7 organizations, including faith-based organizations, 

8 and relevant international and multilateral organiza9 tions, including the GAVI Alliance (formerly known 

10 as the Global Alliance for Vaccines and Immuniza11 tion) and the United Nations Children’s Fund 

12 (UNICEF), giving priority to organizations that 

13 demonstrate effectiveness and commitment to im14 proving the health of newborns, children, and moth15 ers; 

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

17 including civil society and local communities, as well 

18 as other donors and multilateral organizations; 

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

20 other directly-affected populations, especially women 

21 and marginalized communities; and 

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

23 country governments and civil society organizations. 

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

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


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1 report on the implementation of this section for the prior 

2 fiscal year. 

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

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

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

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

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

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

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

10 this Act.’’. 

11 (b) CONFORMING AMENDMENTS.—The Foreign As12 sistance Act of 1961 (22 U.S.C. 2151 et seq.) is amend13 ed— 

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

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

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

17 (2) in section 104B (as redesignated by sub18 section (a)(2) of this section)— 

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

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

21 (B) in subsection (e)(2), by striking ‘‘sec22 tion 104B, and section 104C’’ and inserting 

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

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

25 104(c), this section, section 104B, and section 


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1 104C’’ and inserting ‘‘section 104(c), section 

2 104A, this section, section 104C, and section 

3 104D’’; 

4 (3) in subsection (c) of section 104C (as redes5 ignated by subsection (a)(2) of this section), by in6 serting ‘‘and section 104A’’ after ‘‘section 104(c)’’; 

7 (4) in subsection (c) of section 104D (as redes8 ignated by subsection (a)(2) of this section), by in9 serting ‘‘and section 104A’’ after ‘‘section 104(c)’’; 

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

11 striking ‘‘section 104(c)(2), relating to Child Sur12 vival Fund’’ and inserting ‘‘section 104A’’; and 

13 (6) in section 135(b)— 

14 (A) in paragraph (1), by striking ‘‘section 

15 104A(g)(1)’’ and inserting ‘‘section 

16 104B(g)(1)’’; and 

17 (B) in paragraph (3), by striking ‘‘section 

18 104A(g)(3)’’ and inserting ‘‘section 

19 104B(g)(3)’’. 

20 SEC. 4. STRATEGY TO REDUCE MORTALITY AND IMPROVE 

21 THE HEALTH OF NEWBORNS, CHILDREN, AND 

22 MOTHERS IN DEVELOPING COUNTRIES. 

23 (a) STRATEGY REQUIRED.—The President shall de24 velop and implement a comprehensive United States Gov25 ernment strategy to reduce mortality and improve the 


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1 health of newborns, children, and mothers in developing 

2 countries. 

3 (b) COMPONENTS.—The comprehensive United 

4 States Government strategy developed pursuant to sub5 section (a) shall include the following: 

6 (1) An identification of not less than 60 coun7 tries with priority needs for the 5-year period begin8 ning on the date of the enactment of this Act based 

9 on— 

10 (A) the number and rate of neonatal 

11 deaths; 

12 (B) the number and rate of child deaths; 

13 and 

14 (C) the number and rate of maternal 

15 deaths. 

16 (2) For each country identified in paragraph 

17 (1)— 

18 (A) an assessment of the most common 

19 causes of newborn, child, and maternal mor20 tality; 

21 (B) a description of the programmatic 

22 areas and interventions providing maximum 

23 health benefits to populations at risk as well as 

24 maximum reduction in mortality; 


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1 (C) an assessment of the investments need2 ed in identified programs and interventions to 

3 achieve the greatest results; 

4 (D) a description of how United States as5 sistance complements and leverages efforts by 

6 other donors, as well as builds capacity and 

7 self-sufficiency among recipient countries; and 

8 (E) a description of goals and objectives 

9 for improving maternal, newborn, and child 

10 health, including, to the extent feasible, objec11 tive and quantifiable indicators. 

12 (3) An expansion of the Child Survival and 

13 Health Grants Program of the United States Agency 

14 for International Development, at a minimum pro15 portionate to any increase in child and maternal 

16 health assistance, to provide additional support pro17 grams and interventions determined to be efficacious 

18 and cost-effective in improving health and reducing 

19 mortality. 

20 (4) Enhanced coordination among relevant de21 partments and agencies of the United States Gov22 ernment engaged in activities to improve the health 

23 and well-being of newborns, children, and mothers in 

24 developing countries. 


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1 (5) A description of the measured or estimated 

2 impact on child morbidity and mortality of each 

3 project or program carried out. 

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

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

6 to Congress a report that contains the strategy described 

7 in this section. 

8 SEC. 5. INTERAGENCY TASK FORCE ON CHILD SURVIVAL 

9 AND MATERNAL HEALTH IN DEVELOPING 

10 COUNTRIES. 

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

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

13 Survival and Maternal Health in Developing Countries (in 

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

15 (b) DUTIES.— 

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

17 monitor, and evaluate the progress and contributions 

18 of relevant departments and agencies of the Govern19 ment of the United States in achieving the United 

20 Nations Millennium Development Goals by 2015 for 

21 reducing the mortality of children under the age of 

22 5 by two-thirds (Millennium Development Goal 4) 

23 and reducing maternal mortality by three-quarters 

24 (Millennium Development Goal 5) in developing 

25 countries, including by— 


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1 (A) identifying and evaluating programs 

2 and interventions that directly or indirectly con3 tribute to the reduction of newborn, child, and 

4 maternal mortality rates; 

5 (B) assessing effectiveness of programs, 

6 interventions, and strategies toward achieving 

7 the maximum reduction of newborn, child, and 

8 maternal mortality rates; 

9 (C) assessing the level of coordination 

10 among relevant departments and agencies of 

11 the Government of the United States, the inter12 national community, international organiza13 tions, faith-based organizations, academic insti14 tutions, and the private sector; 

15 (D) assessing the contributions made by 

16 United States-funded programs toward achiev17 ing the Millennium Development Goals 4 and 5; 

18 (E) identifying the bilateral efforts of other 

19 nations and multilateral efforts toward achiev20 ing the Millennium Development Goals 4 and 5; 

21 and 

22 (F) preparing the annual report required 

23 by subsection (f). 

24 (2) CONSULTATION.—To the maximum extent 

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1 viduals with expertise in the matters to be consid2 ered by the Task Force who are not officers or em3 ployees of the Government of the United States, in4 cluding representatives of United States-based non5 governmental organizations (including faith-based 

6 organizations and private foundations), academic in7 stitutions, private corporations, the United Nations 

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

9 (c) MEMBERSHIP.— 

10 (1) NUMBER AND APPOINTMENT.—The Task 

11 Force shall be composed of the following members: 

12 (A) The Administrator of the United 

13 States Agency for International Development. 

14 (B) The Assistant Secretary of State for 

15 Population, Refugees and Migration. 

16 (C) The Coordinator of United States Gov17 ernment Activities to Combat HIV/AIDS Glob18 ally. 

19 (D) The Director of the Office of Global 

20 Health Affairs of the Department of Health 

21 and Human Services. 

22 (E) The Under Secretary for Food, Nutri23 tion and Consumer Services of the Department 

24 of Agriculture. 


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1 (F) The Chief Executive Officer of the Mil2 lennium Challenge Corporation. 

3 (G) The Director of the Peace Corps. 

4 (H) Other officials of relevant departments 

5 and agencies of the Federal Government who 

6 shall be appointed by the President. 

7 (I) Two ex-officio members appointed by 

8 the Speaker of the House of Representatives in 

9 consultation with the minority leader of the 

10 House of Representatives. 

11 (J) Two ex-officio members appointed by 

12 the majority leader of the Senate in consulta13 tion with the minority leader of the Senate. 

14 (2) CHAIRPERSON.—The Administrator of the 

15 United States Agency for International Development 

16 shall serve as chairperson of the Task Force. 

17 (d) MEETINGS.—The Task Force shall meet on a reg18 ular basis, not less often than quarterly, on a schedule 

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

20 starting not later than 90 days after the date of the enact21 ment of this Act. 

22 (e) DEFINITION.—In this subsection, the term ‘‘Mil23 lennium Development Goals’’ means the key development 

24 objectives described in the United Nations Millennium 


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1 Declaration, as contained in United Nations General As2 sembly Resolution 55/2 (September 2000). 

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

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

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

6 Congress and the President a report on the implementa7 tion of this section. 

8 SEC. 6. AUTHORIZATION OF APPROPRIATIONS. 

9 (a) IN GENERAL.—There are authorized to be appro10 priated to carry out this Act, and the amendments made 

11 by this Act, $600,000,000 for fiscal year 2008, 

12 $900,000,000 for fiscal year 2009, $1,200,000,000 for fis13 cal year 2010, and $1,600,000,00 for each of the fiscal 

14 years 2011 and 2012. 

15 (b) AVAILABILITY OF FUNDS.—Amounts appro16 priated pursuant to the authorization of appropriations 

17 under subsection (a) are authorized to remain available 

18 until expended. 

Æ 


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