I

104TH CONGRESS

1ST SESSION H. R. 2052

To amend the Foreign Assistance Act of 1961 to establish and strengthen

policies and programs for the early stabilization of world population

through the global expansion of reproductive choice, and for other

purposes.

IN THE HOUSE OF REPRESENTATIVES

JULY 18, 1995

Mr. BEILENSON (for himself and Mrs. MORELLA) introduced the following

bill; which was referred to the Committee on International Relations

A BILL

To amend the Foreign Assistance Act of 1961 to establish

and strengthen policies and programs for the early stabilization of world population through the global expansion of reproductive choice, 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 ‘‘International Popu5 lation Stabilization and Reproductive Health Act’’.
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1 SEC. 2. AUTHORITIES RELATING TO UNITED STATES POPU2 LATION ASSISTANCE.

3 Part I of the Foreign Assistance Act of 1961 is

4 amended—

5 (1) in section 104(b), by striking ‘‘on such

6 terms and conditions as he may determine’’ and in7 serting ‘‘in accordance with the provisions of chapter

8 12’’; and

9 (2) by adding at the end the following new

10 chapter:

11 ‘‘CHAPTER 12—UNITED STATES

12 POPULATION ASSISTANCE

13 ‘‘SEC. 499. DEFINITION.—For purposes of this chap14 ter, the term ‘United States population assistance’ means

15 assistance provided under section 104(b) of this Act.

16 ‘‘SEC. 499A. CONGRESSIONAL FINDINGS.—The Con17 gress makes the following findings:

18 ‘‘(1) Throughout much of the developing world,

19 the inability of women and couples to exercise choice

20 over childbearing undermines the role of women in

21 economic development, contributes to death and suf22 fering among women and their children, puts pres23 sure on the environment and the natural resources

24 on which many poor families depend for their sur25 vival, and in other ways vitiates the efforts of fami26 lies to lift themselves out of the poverty in which
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1 more than one billion of the world’s 5.6 billion peo2 ple live.

3 ‘‘(2) Through 2015, the world’s population will

4 continue to grow, with annual population increments

5 predicted to be above 86 million. This will lead to a

6 tripling of the world’s population before stabilization

7 can occur.

8 ‘‘(3) As the population within individual coun9 tries grows, cities grow rapidly, movement in and be10 tween countries increases, and regional distributions

11 of population become unbalanced.

12 ‘‘(4) After more than a quarter century of expe13 rience and research, a global consensus is emerging

14 on the need for increased international cooperation

15 in regard to population in the context of sustainable

16 development.

17 ‘‘(5) To act effectively on this consensus, the

18 ability to exercise reproductive choice should be ex19 panded through broader dissemination of fertility

20 regulation services that involve women, couples, and

21 the community and which are competent in meeting

22 individual, family, and community needs and values.

23 ‘‘(6) Although a number of barriers to family

24 planning remain, in many countries a large and

25 growing unmet desire exists for fertility regulation
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1 among women and men who are too poor to pay the

2 full cost of services or for whom services are other3 wise inaccessible. Worldwide, estimates are that

4 more than 350 million couples want to space or pre5 vent another pregnancy, but lack access to family

6 planning methods.

7 ‘‘(7) Millions of women, most of them mothers,

8 are killed or injured each year as a result of unsafe

9 abortions. The availability of safe and effective fer10 tility regulation methods and services and increased

11 access to quality reproductive health care can help

12 prevent many of these tragedies.

13 ‘‘(8) In addition to the personal toll on families,

14 the impact of human population growth and wide15 spread poverty is evident in mounting signs of stress

16 on the world’s environment, particularly in tropical

17 deforestation, erosion of arable land and watersheds,

18 extinction of plant and animal species, global climate

19 change, waste management, and air and water pollu20 tion.

21 ‘‘(9) Traditionally, United States population as22 sistance has not focused on achieving specific goals

23 with respect to international population stabilization

24 or the expansion of reproductive choice. The absence

25 of clear goals in those areas has led to a lack of cri-
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1 teria for allocating funds and evaluating program

2 success.

3 ‘‘SEC. 499B. DECLARATION OF POLICY. (a) IN GEN4 ERAL.—Congress declares that to reduce population

5 growth and stabilize world population at the lowest level

6 feasible and thereby improve the health and well-being of

7 the world’s families, to ensure the role of women in the

8 development process, and to protect the global environ9 ment, an important objective of the foreign policy of the

10 United States shall be to assist the international commu11 nity to achieve universal availability of quality fertility reg12 ulation services through a wide choice of safe and effective

13 means of family planning, including programs of public

14 education and other health and development efforts in

15 support of smaller families.

16 ‘‘(b) FINANCIAL TARGETS.—The Congress endorses

17 a target for global expenditures in developing countries of

18 at least $17,000,000,000 by the year 2000 for population

19 programs described in section 499C, and establishes a goal

20 for United States population assistance by the year 2000

21 of $1,850,000,000 in constant 1993 dollars.

22 ‘‘SEC. 499C. AUTHORIZED ACTIVITIES.—United

23 States population assistance is authorized to provide—

24 ‘‘(1) support for the expansion of quality, af25 fordable, voluntary family planning services, which
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1 emphasize informed choice among a variety of safe

2 and effective fertility regulation methods and closely

3 related reproductive health care services, including

4 the prevention and control of HIV–AIDS, sexually

5 transmitted diseases, and reproductive tract infec6 tions;

7 ‘‘(2) support for adequate and regular supplies

8 of quality contraceptives, quality family planning

9 counseling, information, education, communication,

10 and services emphasizing the use of the mass media

11 to improve public knowledge of fertility regulation

12 and related disease prevention methods and where

13 they may be obtained and to promote the benefits of

14 family planning and reproductive health to individ15 uals, families, and communities;

16 ‘‘(3) support to United States and foreign re17 search institutions and other appropriate entities for

18 biomedical research to develop and evaluate im19 proved methods of safe fertility regulation and relat20 ed disease control, with particular emphasis on

21 methods which—

22 ‘‘(A) are likely to be safer, easier to use,

23 easier to make available in developing country

24 settings, and less expensive than current meth25 ods;
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1 ‘‘(B) are controlled by women, including

2 barrier methods and vaginal microbicides;

3 ‘‘(C) are likely to prevent the spread of

4 sexually transmitted diseases; and

5 ‘‘(D) encourage and allow men to take

6 greater responsibility for their own fertility;

7 ‘‘(4) support for field research on the character8 istics of programs most likely to result in sustained

9 use of effective family planning in meeting each indi10 vidual’s lifetime reproductive goals, with particular

11 emphasis on the perspectives of family planning

12 users, including support for relevant social and be13 havioral research focusing on such factors as the

14 use, nonuse, and unsafe or ineffective use of various

15 fertility regulation and related-disease control meth16 ods;

17 ‘‘(5) support for the development of new evalua18 tion techniques and performance criteria for family

19 planning programs, emphasizing the family planning

20 user’s perspective and reproductive goals;

21 ‘‘(6) support for research and research dissemi22 nation related to population policy development, in23 cluding demographic and health surveys to assess

24 population trends, measure unmet needs, and evalu25 ate program impact, and support for policy-relevant
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1 research on the relationships between population

2 trends, poverty, and environmental management, in3 cluding implications for sustainable agriculture,

4 agroforestry, biodiversity, water resources, energy

5 use, and local and global climate change;

6 ‘‘(7) support for prevention of unsafe abortions

7 and management of complications of unsafe abor8 tions, including research and public information dis9 semination on the health and welfare consequences;

10 ‘‘(8) support for special programs to reach ado11 lescents and young adults before they begin child12 bearing, including health education programs which

13 stress responsible parenthood and the health risks of

14 unprotected sexual intercourse, as well as service

15 programs designed to meet the information and con16 traception needs of adolescents;

17 ‘‘(9) support for a broad array of governmental

18 and nongovernmental communication strategies de19 signed—

20 ‘‘(A) to create public awareness worldwide;

21 ‘‘(B) to generate a consensus on the need

22 to address reproductive health issues and the

23 problems associated with continued world popu24 lation growth;
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1 ‘‘(C) to emphasize the need to educate men

2 as well as women and mobilize their support for

3 reproductive rights and responsibilities; and

4 ‘‘(D) to remove all major remaining bar5 riers to family planning use, including unneces6 sary legal, medical, clinical, and regulatory bar7 riers to information and methods, and to make

8 family planning an established community

9 norm;

10 ‘‘(10) support for programs and strategies that

11 actively discourage harmful practices such as female

12 genital mutilation; and

13 ‘‘(11) support for prenatal, safe delivery pro14 grams and postnatal care programs that include

15 breastfeeding as a child survival strategy and means

16 for enhancing birth spacing.

17 ‘‘SEC. 499D. TERMS AND CONDITIONS.—United

18 States population assistance is authorized to be provided

19 subject to the following conditions:

20 ‘‘(1) Such assistance may only support, directly

21 or through referral, those activities which provide a

22 broad range of fertility regulation methods permitted

23 by individual country policy and a broad choice of

24 public and private family planning services, includ25 ing networks for community-based and subsidized
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1 commercial distribution of high quality contracep2 tives.

3 ‘‘(2) No program supported by United States

4 population assistance may deny an individual family

5 planning services because of such individual’s inabil6 ity to pay all or part of the cost of such services.

7 ‘‘(3) In each recipient country, programs sup8 ported by United States population assistance shall,

9 to the extent possible, support an integrated ap10 proach, consistent with respect for the rights of

11 women as decisionmakers in matters of reproduction

12 and sexuality, for the provision of public and private

13 reproductive health services.

14 ‘‘(4) Family planning services and related re15 productive health care services supported by United

16 States population assistance shall ensure—

17 (A) privacy and confidentiality and main18 tain the highest medical standards possible

19 under local conditions; and

20 (B) regular oversight of the quality of

21 medical care and other services offered, includ22 ing followup care such as care for the side ef23 fects of contraceptive use.

24 ‘‘(5) United States population assistance pro25 grams shall furnish only those contraceptive drugs
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1 and devices which have received approval for mar2 keting in the United States by the Food and Drug

3 Administration or which have been tested and deter4 mined to be safe and effective under research proto5 cols comparable to those required by the Food and

6 Drug Administration or have been determined to be

7 safe by an appropriate international organization or

8 the relevant health authority in the country to which

9 they are provided.

10 ‘‘(6) Family planning services supported by

11 United States population assistance shall be de12 signed to take into account the needs of the family

13 planning user, including the constraints on women’s

14 time, by involving members of the community, in15 cluding both men and women, in the design, man16 agement, and ongoing evaluation of the services

17 through appropriate training and recruitment ef18 forts. The design of services shall stress easy acces19 sibility, by locating services as close as possible to

20 potential users, by keeping hours of service conven21 ient, and by improving communications between

22 users and providers through community outreach

23 and involvement. Related services shall be included,

24 either on site or through referral.
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1 ‘‘(7) United States population assistance to ad2 olescent fertility programs shall be provided in the

3 context of prevailing norms and customs in the re4 cipient country.

5 ‘‘(8)(A) Programs supported by United States

6 population assistance shall—

7 ‘‘(i) support the prevention of the spread

8 of HIV–AIDS infection;

9 ‘‘(ii) raise awareness regarding HIV–AIDS

10 prevention and consequences; and

11 ‘‘(iii) provide quality counselling, medical

12 care and support services to HIV–AIDS in13 fected individuals in a manner which respects

14 individual rights and confidentiality.

15 ‘‘(B) Responsible sexual behavior, including vol16 untary abstinence, for the prevention of HIV infec17 tion should be promoted and included in education

18 and information programs.

19 ‘‘(9) None of the funds made available by the

20 United States Government to foreign governments,

21 international organizations, or nongovernmental or22 ganizations may be used to coerce any person to un23 dergo contraceptive sterilization or involuntary abor24 tion or to accept any other method of fertility regu25 lation.
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1 ‘‘SEC. 499E. ELIGIBILITY FOR POPULATION ASSIST2 ANCE. (a) ELIGIBLE COUNTRIES.—Notwithstanding any

3 other provision of law, United States population assistance

4 shall be available, directly or through intermediary organi5 zations, to any country which the President determines

6 has met one or more of the following criteria:

7 ‘‘(1) The country accounts for a significant pro8 portion of the world’s annual population increment.

9 ‘‘(2) The country has significant unmet needs

10 for fertility regulation and requires foreign assist11 ance to implement, expand, or sustain quality family

12 planning services for all its people.

13 ‘‘(3) The country demonstrates a strong policy

14 commitment to population stabilization through the

15 expansion of reproductive choice.

16 ‘‘(b) ELIGIBILITY OF NONGOVERNMENTAL AND MUL17 TILATERAL ORGANIZATIONS.—In determining eligibility

18 for United States population assistance, the President

19 shall not subject nongovernmental and multilateral organi20 zations to requirements which are more restrictive than

21 requirements applicable to foreign governments for such

22 assistance.

23 ‘‘SEC. 499F. PARTICIPATION IN MULTILATERAL OR24 GANIZATIONS. (a) FINDING.—The Congress recognizes

25 that the recent attention, in government policies toward
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1 population stabilization owes much to the efforts of the

2 United Nations and its specialized agencies and organiza3 tions, particularly the United Nations Population Fund.

4 ‘‘(b) AVAILABILITY OF FUNDS.—United States popu5 lation assistance shall be available for contributions to the

6 United Nations Population Fund in such amounts as the

7 President determines would be commensurate with United

8 States contributions to other multilateral organizations

9 and with the contributions of other donor countries.

10 ‘‘(c) PROHIBITIONS.—(1) The prohibitions contained

11 in section 104(f) of this Act shall apply to the funds made

12 available for the United Nations Population Fund.

13 ‘‘(2) No United States population assistance may be

14 available to the United Nations Population Fund unless

15 such assistance is held in a separate account and not com16 mingled with any other funds.

17 ‘‘(3) No funds may be available for the United Na18 tions Population Fund unless the Fund agrees to prohibit

19 the use of those funds to carry out any program, project,

20 or activity that involves the use of coerced abortion or in21 voluntary sterilization.

22 ‘‘(d) ALLOCATION OF FUNDS.—Of the funds made

23 available for United States population assistance, the

24 President shall make available for the Special Programme

25 of Research, Development and Research Training in
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1 Human Reproduction for each of the fiscal years 1996 and

2 1997 an amount commensurate with the contributions of

3 the other donor countries for the purpose of furthering

4 international cooperation in the development and evalua5 tion of fertility regulation technology.

6 ‘‘SEC. 499G. SUPPORT FOR NONGOVERNMENTAL OR7 GANIZATIONS. (a) FINDING.—Congress finds that in many

8 developing countries, nongovernmental entities, including

9 private and voluntary organizations and private sector en10 tities, such as the International Planned Parenthood Fed11 eration and the Planned Parenthood Federation of Amer12 ica, are the most appropriate and effective providers of

13 United States assistance to population and family plan14 ning activities.

15 ‘‘(b) PROCEDURES.—The President shall establish

16 simplified procedures for the development and approval of

17 programs to be carried out by nongovernmental organiza18 tions that have demonstrated—

19 ‘‘(1) a capacity to undertake effective popu20 lation and family planning activities which encourage

21 significant involvement by private health practition22 ers, employer-based health services, unions, and co23 operative health organizations; and

24 ‘‘(2) a commitment to quality reproductive

25 health care for women.
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1 ‘‘(c) PRIORITY FOR NONGOVERNMENTAL ORGANIZA2 TIONS.—The largest share of United States population as3 sistance made available for any fiscal year shall be made

4 available through United States and foreign nongovern5 mental organizations.

6 ‘‘SEC. 499H. REPORTS TO CONGRESS.—The Presi7 dent shall prepare and submit to the Congress, as part

8 of the annual presentation materials on foreign assistance,

9 a report on world progress toward population stabilization

10 and universal reproductive choice. The report shall in11 clude—

12 ‘‘(1) estimates of expenditures on the popu13 lation activities described in section 499C by na14 tional governments, donor agencies, and private sec15 tor entities;

16 ‘‘(2) an assessment by country, of the availabil17 ity and use of all methods of fertility regulation and

18 abortion, whether lawful or unlawful in that country;

19 ‘‘(3) an analysis by country and region of the

20 impact of population trends on a set of key social,

21 economic, political, and environment indicators,

22 which shall be identified by the President in the first

23 report submitted pursuant to this section and ana24 lyzed in that report and each subsequent report; and
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1 ‘‘(4) a detailed statement of prior year and pro2 posed direct and indirect allocations of population

3 assistance, by country, which describes how each

4 country allocation meets the criteria set forth in this

5 section.’’.

6 SEC. 3. AUTHORIZATIONS OF APPROPRIATIONS.

7 Section 104(g)(1) of the Foreign Assistance Act of

8 1961 (22 U.S.C. 2151b(g)(1) is amended by amending

9 subparagraph (A) to read as follows:

10 ‘‘(A) $635,000,000 for fiscal year 1996 and

11 $695,000,000 for fiscal year 1997 to carry out sub12 section (b) of this section; and’’.

13 SEC. 4. OVERSIGHT OF MULTILATERAL DEVELOPMENT

14 BANKS.

15 (a) FINDINGS.—The Congress finds that—

16 (1) multilateral development banks have an im17 portant role to play in global population efforts;

18 (2) although the increased commitment by mul19 tilateral development banks to population-related ac20 tivities is encouraging, together the banks provided

21 less than $200,000,000 in 1994 in assistance for

22 core population programs, and their overall lending

23 for population, health, and nutrition decreased by

24 more than one-half between 1993 and 1994; and
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1 (3) the banks themselves have recognized a

2 need to improve oversight of programs, strengthen

3 the technical skills of their personnel, and improve

4 their capacity to work with borrowers, other donors,

5 and nongovernmental organizations in formulating

6 creative population projects to meet diverse borrower

7 needs.

8 (b) SENSE OF CONGRESS.—It is the sense of the

9 Congress that the multilateral development banks should

10 increase their annual support for the population activities

11 described in section 499C of the Foreign Assistance Act

12 of 1961, as added by this Act, to not less than a total

13 of $1,000,000,000 by December 31, 2000.

14 (c) REPORT REQUIRED.—Not later than July 31 of

15 each year, the Secretary of the Treasury shall prepare and

16 transmit to Congress a report which includes, with respect

17 to the preceding calendar year—

18 (1) information on the resources made available

19 by each multilateral development bank for the popu20 lation activities described in section 499C of the

21 Foreign Assistance Act of 1961, as added by this

22 Act;

23 (2) if such resources total less than

24 $1,000,000,000, any specific actions taken by the

25 United States executive directors to the banks to en-
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1 courage increases in such resources and in policy2 level discussions with donor and developing country

3 governments; and

4 (3) an analysis of the progress made by the

5 banks towards—

6 (A) meeting the objectives of the popu7 lation activities which are supported by the

8 banks;

9 (B) increasing their in-country manage10 ment staff;

11 (C) improving the technical skills of their

12 personnel; and

13 (D) assuring their responsiveness to bor14 rower needs.

15 (d) DEFINITION.—As used in this section, the term

16 ‘‘multilateral development banks’’ means the International

17 Bank for Reconstruction and Development, the Inter18 national Development Association, the African Develop19 ment Bank, the Asian Development Bank, the Inter20 American Development Bank, and the European Bank for

21 Reconstruction and Development.

22 SEC. 5. REPORT ON WORLD CONFERENCE ON WOMEN.

23 (a) REPORT.—Not later than August 1, 1995, the

24 Secretary shall submit to the Congress a public report on

25 preparations for United States participation in the 1995
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1 World Conference on Women, including information on

2 public hearings and conferences to be held in relation to

3 the Conference. The report, which should be made avail4 able for consideration at the 1995 World Conference on

5 Women, shall specify, among other things—

6 (1) modifications in policy and financial com7 mitments required by United States and foreign gov8 ernments to achieve universal reproductive choice

9 and early population stabilization;

10 (2) information on the burden of poverty on

11 women, including international statistics on women

12 in poverty and female-headed households;

13 (3) current data on gender inequality in access

14 to education and health care services;

15 (4) information on violence against women, in16 cluding current data on causes and incidence, new

17 methods for addressing violence against women, and

18 proposals for preventing and eradicating violence

19 against women;

20 (5) information on women’s access to and par21 ticipation in the development of economic structures

22 and policies and in local and national economies in

23 general, including current data on occupational seg24 regation, wage inequality, and access to credit and

25 technology; and
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1 (6) current comparative data on men and

2 women in political positions, legislative bodies, and

3 decisionmaking positions at all levels, and informa4 tion on the structural and attitudinal barriers

5 women face in these areas.

6 SEC. 6. ECONOMIC AND SOCIAL DEVELOPMENT INITIA7 TIVES TO STABILIZE WORLD POPULATION.

8 (a) CONGRESSIONAL FINDINGS.—The Congress

9 makes the following findings:

10 (1) Women represent 50 percent of the world’s

11 human resource potential. Therefore, improving the

12 health, social, and economic status of women and in13 creasing their productivity are essential for economic

14 progress in all countries. Improving the status of

15 women also enhances their decisionmaking capacity

16 at all levels in all spheres of life, including in the

17 area of reproductive health.

18 (2) Throughout the world, women who partici19 pate in the social, economic, and political affairs of

20 their communities are more likely to exercise their

21 choice about childbearing than women who do not

22 participate in such activities.

23 (3) Effective economic development strategies

24 address issues such as infant and child survival
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1 rates, educational opportunities for girls and women,

2 and gender equality in development.

3 (4) Comprehensive population stabilization ef4 forts which include both family planning services

5 and economic development activities achieve lower

6 birth rates and stimulate more development than

7 those which pursue these objectives independently.

8 (5) The most powerful, long-term influence on

9 birthrates is education, especially educational attain10 ment among women. Education is one of the most

11 important means of empowering women with the

12 knowledge, skills and self confidence necessary to

13 participate in their communities.

14 (6) In most societies, men traditionally have ex15 ercised preponderant power in nearly all spheres of

16 life. Therefore, improving communication between

17 men and women on reproductive health issues and

18 increasing their understanding of joint responsibil19 ities are essential to ensuring that men and women

20 are equal partners in public and private life.

21 (7) In addition to enabling women to partici22 pate in the development of their societies, edu23 cational attainment has a strong influence on all

24 other aspects of family welfare, including child sur25 vival. However, of the world’s 130 million children
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1 who are not enrolled in primary school, 70 percent

2 are girls.

3 (8) In a number of countries, lower rates of

4 school enrollment among girls, the practice of pre5 natal sex selection, and higher rates of mortality

6 among very young girls suggest that ‘‘son pref7 erence’’ is curtailing the access of girl children to

8 food, health care, and education.

9 (9) Each year, nearly 15 million children under

10 the age of 5 die, most from preventable causes.

11 Wider availability of vaccines, simple treatments for

12 diarrheal disease and respiratory infections, and im13 proved nutrition could prevent many of these deaths.

14 (10) Each year, 500,000 or more women world15 wide die from complications related to pregnancy,

16 childbirth, illegal abortion, or inadequate or inacces17 sible reproductive health care services. Another 10

18 million women annually suffer long-term illness or

19 permanent physical impairment from such causes.

20 (11) Malnutrition and anemia are widespread

21 among poor women in their childbearing years, yet

22 the worldwide campaign to encourage breastfeeding

23 has devoted little attention to the nutritional needs

24 of nursing mothers.
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1 (12) By mid-1993, the cumulative number of

2 AIDS cases since the pandemic began was estimated

3 at 2.5 million, and an estimated 14 million people

4 had been infected with HIV. By year 2000, esti5 mates are that 40 million people will be HIV in6 fected.

7 (13) As of mid-1993, four-fifths of all persons

8 ever infected with HIV lived in developing countries.

9 Women are the fastest growing group of new cases.

10 (b) DECLARATION OF POLICY.—Congress declares

11 that, to further the United States foreign policy objective

12 of assisting the international community in achieving uni13 versal availability of quality fertility regulation services

14 and stabilizing world population, additional objectives of

15 the foreign policy of the United States shall be—

16 (1) to help achieve universal access to basic

17 education for women and men, with particular prior18 ity being given to primary and technical education

19 and job training;

20 (2) to increase understanding of the con21 sequences of population growth through effective

22 education strategies that begin in primary school

23 and continue through all levels of formal and

24 nonformal education and which take into account
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1 the rights and responsibilities of parents and the

2 needs of children and adolescents;

3 (3) to reduce the gap between male and female

4 levels of literacy and between male and female levels

5 of primary and secondary school enrollment;

6 (4) to help ensure that women worldwide have

7 the opportunity to become equal partners with men

8 in the development of their societies;

9 (5) to help eliminate all forms of discrimination

10 against girl children and the root causes of son pref11 erence, which result in harmful and unethical prac12 tice such as female infanticide and prenatal sex se13 lection;

14 (6) to increase public awareness of the value of

15 girl children through public education that promotes

16 equal treatment of girls and boys in health, nutri17 tion, education, socioeconomic and political activity,

18 and equitable inheritance rights;

19 (7) to promote gender equality in all spheres of

20 life, including family and community life, and to en21 courage and enable men to take responsibility for

22 their sexual and reproductive behavior and their so23 cial and family roles;

24 (8) to help ensure that women and men have

25 the information and means needed to achieve good
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1 reproductive health and to exercise their reproduc2 tive rights through responsible sexual behavior and

3 equity in gender relations;

4 (9) to reduce global maternal and infant mor5 tality rates; and

6 (10) to improve worldwide maternal and child

7 health status and quality of life.

8 (c) AUTHORIZED ACTIVITIES.—United States devel9 opment assistance shall be available, on a priority basis,

10 for—

11 (1) countries which either have adopted and im12 plemented, or have agreed to adopt and implement,

13 strategies to help ensure—

14 (A) before 2015, the achievement of the

15 goal of universal primary education for girls

16 and boys in all countries and access to second17 ary and higher levels of education, including vo18 cational education and technical training, for

19 girls and women;

20 (B) by 2005, the reduction of adult illit21 eracy by at least one-half the country’s 1990

22 level;

23 (C) by 2005, the elimination of the gap be24 tween male and female levels of literacy and be-
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1 tween male and female levels of primary and

2 secondary school enrollment; and

3 (D) the establishment of programs de4 signed to meet adolescent health needs, which

5 include services and information on responsible

6 sexual behavior, family planning practice, repro7 ductive health and sexually transmitted dis8 eases, and HIV–AIDS prevention;

9 (2) governmental and nongovernmental pro10 grams which, with respect to a targeted country, are

11 intended—

12 (A) by 2005, to increase life expectancy at

13 birth to greater than 70 years of age and by

14 2015, to 75 years of age;

15 (B) by 2005, to reduce by one-third the

16 country’s mortality rates for infants and chil17 dren under 5 years of age, or to 50 per 1,000

18 live births for infants and 70 per 1,000 for chil19 dren under 5 years of age, whichever is less;

20 and by 2015, to reduce the country’s infant

21 mortality rate below 35 per 1,000 births and

22 the under-5 mortality rate below 45 per 1,000;

23 (C) by 2005, to reduce maternal mortality

24 by one-half of the 1990 level and by a further

25 one-half by 2015;
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1 (D) by 2005, to reduce significantly mal2 nutrition among the country’s children under 5

3 years of age;

4 (E) to maintain immunizations against

5 childhood diseases for significant segments of

6 the country’s children; and

7 (F) to reduce the number of childhood

8 deaths in the country which result from diar9 rheal disease and acute respiratory infections;

10 (3) governmental and nongovernmental pro11 grams which are intended to increase women’s pro12 ductivity and ensure equal participation and equi13 table representation at all levels of the political proc14 ess and public life in each community and society

15 through—

16 (A) improved access to appropriate labor17 saving technology, vocational training, and ex18 tension services and access to credit and child

19 care;

20 (B) equal participation of women and men

21 in all areas of family and household responsibil22 ities, including family planning, financial sup23 port, child rearing, children’s education, and

24 maternal and child health and nutrition;
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1 (C) fulfillment of the potential of women

2 through education, skill development and em3 ployment, with the elimination of poverty, illit4 eracy and poor health among women being of

5 paramount importance; and

6 (D) recognition and promotion of the equal

7 value of children of both sexes;

8 (4) governmental and nongovernmental pro9 grams which are intended to increase the access of

10 girls and women to comprehensive reproductive

11 health care services pursuant to subsection (d); and

12 (5) governmental and nongovernmental pro13 grams which are intended to eliminate all forms of

14 exploitation, abuse, harassment, and violence against

15 women, adolescents, and children.

16 (d) SAFE MOTHERHOOD INITIATIVE.—(1)(A) The

17 President is authorized to establish a grant program, to

18 be known as the Safe Motherhood Initiative, to help im19 prove the access of girls and women worldwide to com20 prehensive reproductive health care services.

21 (B) Such program shall be carried out in accordance

22 with this section and shall be subject to the same terms,

23 conditions, prohibitions, and restrictions as are applicable

24 to assistance made available under sections 499D, 499E,
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1 and 499F of the Foreign Assistance Act of 1961, as added

2 by this Act.

3 (2) Comprehensive reproductive health care programs

4 which are eligible for assistance under this section in5 clude—

6 (A) fertility regulation services;

7 (B) prenatal care and screening for high risk

8 pregnancies and improved access to safe delivery

9 services for women with high risk pregnancies;

10 (C) supplemental food programs for pregnant

11 and nursing women;

12 (D) child survival and other programs that pro13 mote birth spacing through breastfeeding;

14 (E) expanded and coordinated programs that

15 support responsible sexual behavior, including vol16 untary abstinence, and which prevent, detect, and

17 treat sexually transmitted diseases, including HIV–

18 AIDS, reproductive tract infections, and other

19 chronic reproductive health problems;

20 (F) programs intended to eliminate traditional

21 practices injurious to women’s health, including fe22 male genital mutilation;

23 (G) improvements in the practice of midwifery,

24 including outreach to traditional birth attendants;

25 and
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1 (H) expanded and coordinated programs to pre2 vent, detect, and treat cancers of the reproductive

3 system.

4 (e) REPORTS TO CONGRESS.—(1) Not later than De5 cember 31, 1995, the President shall prepare and submit

6 to Congress a report which includes—

7 (A) estimates of the total financial resources

8 needed to achieve, by the year 2005, the specific ob9 jectives set forth in subsection (c) with respect to

10 education, rates of illiteracy, malnutrition, immuni11 zation, maternal and child mortality and morbidity,

12 and improvements in the economic productivity of

13 women;

14 (B) an analysis of such estimates which sepa15 rately lists the total financial resources needed from

16 the United States, other donor nations, and non17 governmental organizations;

18 (C) an analysis, by country, which—

19 (i) identifies the legal, social, economic,

20 and cultural barriers to women’s self-determina21 tion and to improvements in the economic pro22 ductivity of women in traditional and modern

23 labor sectors; and

24 (ii) describes initiatives needed to develop

25 appropriate technologies for use by women,
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1 credit programs for low-income women, ex2 panded child care, vocational training, and ex3 tension services for women; and

4 (D) a comprehensive description of—

5 (i) new and expanded initiatives to ensure

6 safe motherhood worldwide;

7 (ii) findings on the major causes of mortal8 ity and morbidity among women of childbearing

9 age in various regions of the world;

10 (iii) actions needed to reduce, by the year

11 2005, world maternal mortality by one-half of

12 the worldwide 1990 level and a further one-half

13 by 2015; and

14 (iv) the financial resources needed to meet

15 this goal from the United States, other donor

16 nations, and nongovernmental organizations.

17 (2) In each annual country human rights report, the

18 Secretary of State shall include—

19 (A) information on any patterns within the

20 country of discrimination against women in inherit21 ance laws, property rights, family law, access to

22 credit and technology, hiring practices, formal edu23 cation, and vocational training; and

24 (B) an assessment which makes reference to all

25 significant forms of violence against women, includ-
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1 ing rape, domestic violence, and female genital muti2 lation, the extent of involuntary marriage and child3 bearing, and the prevalence of marriage among

4 women under 18 years of age.

5 (f) AUTHORIZATION OF APPROPRIATIONS.—(1) Of

6 the aggregate amounts available for United States devel7 opment and economic assistance programs for education

8 activities, $165,000,000 for fiscal year 1996 and

9 $200,000,000 for fiscal year 1997 shall be available only

10 for programs in support of increasing primary and second11 ary school enrollment and equalizing levels of male and

12 female enrollment.

13 (2) There are authorized to be appropriated

14 $330,000,000 for fiscal year 1996 and $380,000,000 for

15 fiscal year 1997 to the Child Survival Fund under section

16 104(c)(2) of the Foreign Assistance Act of 1961, which

17 amounts shall be available for child survival activities only,

18 including the Children’s Vaccine Initiative, the worldwide

19 immunization effort, and oral rehydration programs.

20 (3) There are authorized to be appropriated

21 $100,000,000 for the Safe Motherhood Initiative for each

22 of fiscal years 1995 and 1996.

23 (g) DEFINITIONS.—For purposes of this section—

24 (1) the term ‘‘annual country human rights re25 port’’ refers to the report required to be submitted
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1 pursuant to section 502B(b) of the Foreign Assist2 ance Act of 1961 (22 U.S.C. 2304(b)); and

3 (2) the term ‘‘United States development and

4 economic assistance’’ means assistance made avail5 able under chapter 1 of part I and chapter 4 of part

6 II of the Foreign Assistance Act of 1961.

7 SEC. 7. AIDS PREVENTION AND CONTROL FUND.

8 (a) IN GENERAL.—Section 104(c) of the Foreign As9 sistance Act of 1961 (22 U.S.C. 2151b(c)) is amended by

10 adding at the end the following new paragraph:

11 ‘‘(4)(A)(i) The President is authorized to provide as12 sistance, under such terms and conditions as he may de13 termine, with respect to activities relating to research on,

14 and the treatment and control of, acquired immune defi15 ciency syndrome (AIDS) in developing countries.

16 ‘‘(ii) Assistance provided under clause (i) shall in17 clude—

18 ‘‘(I) funds made available directly to the World

19 Health Organization for its use in financing the

20 Global Program on AIDS (including activities imple21 mented by the Pan American Health Organization);

22 and

23 ‘‘(II) funds made available to the United Na24 tions Children’s Fund (UNICEF) for AIDS-related

25 activities.
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1 ‘‘(B) Appropriations pursuant to subparagraph (A)

2 may be referred to as the ‘AIDS Prevention and Control

3 Fund’.’’.

4 (b) AUTHORIZATION OF APPROPRIATIONS.—Section

5 104(g)(1) of the Foreign Assistance Act of 1961 (22

6 U.S.C. 2151b(g)) is amended—

7 (1) by striking ‘‘and’’ at the end of subpara8 graph (A);

9 (2) in subparagraph (B), by striking ‘‘sub10 section (c) of this section.’’ and inserting ‘‘sub11 section (c) of this section (other than paragraph (4)

12 thereof); and’’; and

13 (3) by adding at the end thereof the following

14 new subparagraph:

15 ‘‘(C) $125,000,000 for fiscal year 1996

16 and $145,000,000 for fiscal year 1997 to carry

17 out subsection (c)(4) of this section.’’.

18 (c) EFFECTIVE DATE.—The amendments made by

19 this section shall take effect October 1, 1995.

20 SEC. 8. SUPPORT FOR UNITED NATIONS FORWARD LOOK21 ING STRATEGIES FOR THE ADVANCEMENT OF

22 WOMEN.

23 (a) IN GENERAL.—The President shall direct the

24 United States representatives to the United Nations Com25 mission on the Status of Women to take all actions nec-
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1 essary to ensure the rapid implementation of the United

2 Nations Forward Looking Strategies for the Advancement

3 of Women, as adopted in 1985 at the United Nations Con4 ference ending the Decade for Women.

5 (b) REVIEW AND ANNUAL REPORTS.—Not later than

6 December 31, 1995, the Secretary of State shall submit

7 the 5-year review of the status of United States women,

8 as called for at the conference, and shall submit such an9 nual reports as are requested by the United Nations Com10 mission on the Status of Women.

11 SEC. 9. SUPPORT FOR THE CONVENTION ON THE ELIMI12 NATION OF ALL FORMS OF DISCRIMINATION

13 AGAINST WOMEN.

14 The President shall promptly complete the review of

15 the United Nations Convention on the Elimination of All

16 Forms of Discrimination Against Women, which was

17 signed by the United States on July 17, 1980, and submit

18 to the Senate any reservations, understandings, or dec19 larations that the President considers necessary in order

20 that the Senate may give its advice and consent to ratifica21 tion, or report to the Congress why he is unable or unwill22 ing to do so.

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