II 

117TH CONGRESS 

1ST SESSION S. 2956 

To advance targeted, high-impact, and evidence-based interventions for the 

prevention and treatment of global malnutrition, to improve the coordination of such programs, and for other purposes. 

IN THE SENATE OF THE UNITED STATES 

OCTOBER 7, 2021 

Mr. COONS (for himself, Mr. WICKER, Mr. KAINE, and Mr. BOOZMAN) introduced the following bill; which was read twice and referred to the Committee on Foreign Relations 

A BILL 

To advance targeted, high-impact, and evidence-based interventions for the prevention and treatment of global malnutrition, to improve the coordination of such programs, 

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 ‘‘Global Malnutrition 

5 Prevention and Treatment Act of 2021’’. 

6 SEC. 2. NUTRITION PROGRAMS. 

7 (a) IN GENERAL.—The Administrator of the United 

8 States Agency for International Development, in coordinaVerDate Sep 11 2014 23:26 Oct 08, 2021 Jkt 029200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6201 E:\BILLS\S2956.IS S2956

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1 tion with relevant Federal departments and agencies, is 

2 authorized and encouraged to scale up the prevention and 

3 treatment of global malnutrition, including by supporting 

4 efforts— 

5 (1) to target high-impact and evidence-based re6 sources and nutrition interventions to support the 

7 most vulnerable populations, including children 

8 younger than 5 years of age and pregnant and lac9 tating women, susceptible to severe malnutrition, in10 cluding both stunting and wasting; 

11 (2) to increase coverage, particularly within pri12 ority countries, of high-impact and evidence-based 

13 nutrition interventions that include coordinated de14 ployment of prenatal vitamins, breastfeeding sup15 port, vitamin A supplementation, emergency thera16 peutic food, and other evidence-based interventions 

17 as appropriate; 

18 (3) to increase the use of context and country19 appropriate fortification of staples and condiments 

20 with essential nutrients; 

21 (4) to advance evidence-based programs and 

22 interventions carried out using data-driven ap23 proaches, best practices, and targeted to country24 specific contexts and needs; 


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1 (5) to support the development of country-spe2 cific policies to prevent and treat malnutrition; 

3 (6) to leverage investments to strengthen pri4 mary health systems and support community health 

5 workers in order to advance improved nutrition out6 comes; and 

7 (7) to ensure rigorous monitoring and evalua8 tion of all nutrition programs and interventions. 

9 (b) COORDINATION.—The Administrator of the 

10 United States Agency for International Development, in 

11 coordination with relevant Federal departments and agen12 cies, should coordinate with bilateral and multilateral do13 nors, partner country governments, United Nations agen14 cies, civil society, nongovernmental organizations, includ15 ing faith-based organizations, and the private sector to 

16 scale up efforts to prevent and treat global malnutrition, 

17 including by— 

18 (1) building the capacity of local and commu19 nity-based organizations and partner country gov20 ernments to expand coverage and ensure sustain21 ability of nutrition interventions; 

22 (2) expanding research and innovation to iden23 tify and scale effective and evidence-based nutrition 

24 interventions based on country-specific contexts; 


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1 (3) improving the coordination of nutrition 

2 interventions, including within the United Nations; 

3 (4) leveraging additional resources and ensuring 

4 appropriate burden-sharing to support nutrition 

5 interventions in priority countries; 

6 (5) expanding domestic resource mobilization 

7 and domestic financing for nutrition interventions; 

8 and 

9 (6) encouraging investment into innovative and 

10 multistakeholder finance partnerships. 

11 SEC. 3. PRIORITY COUNTRIES. 

12 (a) DESIGNATION.—The Administrator, in coordina13 tion with the Nutrition Leadership Council, shall— 

14 (1) designate certain countries as ‘‘priority 

15 countries’’ for the purposes of prioritizing programs 

16 to prevent and treat malnutrition; and 

17 (2) not later than 5 years after the date of the 

18 enactment of this Act, review and update such des19 ignations based on the criteria described in sub20 section (b). 

21 (b) CRITERIA.—In selecting priority countries under 

22 subsection (a), the Administrator should consider— 

23 (1) the prevalence of severe malnutrition among 

24 children younger than 5 years of age and pregnant 

25 and lactating women; 


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1 (2) the presence of high-need, underserved, 

2 marginalized, vulnerable, or impoverished commu3 nities; 

4 (3) the enabling environment for improved nu5 trition, including the presence of national nutrition 

6 plans and the demonstration of strong political com7 mitment; and 

8 (4) other appropriate factors. 

9 (c) SENSE OF CONGRESS.—It is the sense of Con10 gress that the Administrator should continue to undertake 

11 nutrition interventions in countries that are not selected 

12 as priority countries, particularly if opportunities are iden13 tified to advance multi-sectoral development programming 

14 and to integrate efforts to prevent and treat global mal15 nutrition with other priority areas and program objectives. 

16 SEC. 4. COORDINATION. 

17 (a) NUTRITION LEADERSHIP COUNCIL.—There is es18 tablished at the United States Agency for International 

19 Development (referred to in this section as ‘‘USAID’’), the 

20 Nutrition Leadership Council (referred to in this section 

21 as the ‘‘Council’’), which shall coordinate efforts by 

22 USAID to prevent and treat malnutrition globally. 

23 (b) DUTIES.—The Council shall— 

24 (1) advance efforts by USAID to prevent and 

25 treat malnutrition globally; 


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1 (2) ensure that nutrition interventions, particu2 larly within priority countries, are carried out in 

3 close coordination with and aligned with existing 

4 United States Government and USAID strategies, 

5 including— 

6 (A) the Senator Paul Simon Water for the 

7 World Act of 2014 (Public Law 113–289); 

8 (B) the Global Food Security Act of 2016 

9 (22 U.S.C. 9301 et seq.); 

10 (C) the Global Fragility Act of 2019 (22 

11 U.S.C. 9801 et seq.); and 

12 (D) the Global Child Thrive Act of 2020 

13 (subtitle I of title XII of division A of Public 

14 Law 116–283); and 

15 (3) ensure that nutrition programs and inter16 ventions are coordinated with nutrition programs 

17 carried out by other relevant Federal departments 

18 and agencies. 

19 (c) MEMBERSHIP.—The Council shall include rep20 resentatives of— 

21 (1) the Bureau for Global Health; 

22 (2) the Bureau for Resilience and Food Secu23 rity; 

24 (3) the Bureau for Humanitarian Assistance; 

25 and 


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1 (4) other appropriate USAID bureaus and of2 fices. 

3 (d) INTERAGENCY EFFORTS.—In carrying out the 

4 activities described in section 2, the Administrator, in co5 ordination with relevant Federal departments and agen6 cies, shall seek to leverage additional private sector re7 sources to prevent and treat malnutrition in priority coun8 tries by— 

9 (1) increasing cooperation between USAID, the 

10 Millennium Challenge Corporation, the United 

11 States International Development Finance Corpora12 tion, and other relevant Federal departments and 

13 agencies to better leverage the full spectrum of 

14 grants, technical assistance, debt, equity, loan guar15 anty tools, and public-private partnerships to pre16 vent and treat global malnutrition; 

17 (2) utilizing the Administrator’s role as Devel18 opment Finance Corporation Vice Chair to consider 

19 opportunities within the Development Finance Cor20 poration’s development impact framework that sup21 port improved nutrition outcomes; and 

22 (3) exploring opportunities to advance burden23 sharing in nutrition-related assistance. 


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1 SEC. 5. IMPLEMENTATION PLAN. 

2 (a) IN GENERAL.—Not later than 260 days after the 

3 date of the enactment of this Act, the Administrator, in 

4 coordination with other relevant Federal departments and 

5 agencies, shall develop and submit to the appropriate con6 gressional committees an implementation plan to prevent 

7 and treat global malnutrition and carry out the activities 

8 authorized under section 2. 

9 (b) CONTENTS.—The implementation plan required 

10 under subsection (a) shall— 

11 (1) establish specific and measurable goals, ob12 jectives, and performance metrics towards prevention 

13 and treatment of global malnutrition, including clear 

14 benchmarks and intended timelines for achieving 

15 such goals and objectives; 

16 (2) establish baseline measurements and time17 bound targets for increasing coverage of key nutri18 tion interventions in priority countries, which may 

19 include scaling up to— 

20 (A) 80-percent coverage for— 

21 (i) vitamin A (to be measured by the 

22 proportion of children 6 to 59 months old 

23 receiving 2 high-dose vitamin A supple24 ments in a given year); 

25 (ii) prenatal vitamins (measured by 

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1 ceived multiple micronutrient supplemen2 tation daily); and 

3 (iii) breastfeeding (as measured by 

4 proportion of mothers of children between 

5 0 and 5 months of age reached by pro6 motion of breastfeeding activities); and 

7 (B) 50-percent coverage for treatment of 

8 wasting (as measured by the proportion of chil9 dren 6 to 59 months with severe acute mal10 nutrition receiving therapeutic feeding treat11 ment); 

12 (3) require monitoring and evaluation plans for 

13 all nutrition programs and activities, as appropriate; 

14 (4) in countries that were selected as priority 

15 countries, ensure that nutrition is adequately ad16 dressed within the Country Development Coopera17 tion Strategy to the extent practicable and identify 

18 opportunities to expand efforts to prevent and treat 

19 malnutrition, including through leveraging existing 

20 health and development programs and other ongoing 

21 activities; and 

22 (5) require all USAID grants, contracts, and 

23 cooperative agreements for the purposes of the treat24 ment or prevention of severe malnutrition to include 

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1 tion interventions, including the establishment of 

2 baseline measurements from which to quantify 

3 progress. 

4 (c) STAKEHOLDER CONSULTATION.—The implemen5 tation plan required under this section shall be developed 

6 in consultation with, as appropriate, representatives of 

7 nongovernmental organizations, including faith-based or8 ganizations, civil society groups, multilateral organizations 

9 and donors, relevant private, academic, and philanthropic 

10 entities, and the appropriate congressional committees. 

11 SEC. 6. REPORTING REQUIREMENTS. 

12 (a) ANNUAL REPORT.—Not later than 1 year after 

13 the date of the enactment of this Act, and annually there14 after for 5 additional years, the Administrator shall sub15 mit a report to the appropriate congressional committees 

16 that describes the progress made towards preventing and 

17 treating malnutrition, including— 

18 (1) a summary of the progress made towards 

19 achieving the specific and measurable goals, objec20 tives, and performance metrics towards ending glob21 al malnutrition identified as required under section 

22 5(b)(1); 

23 (2) in countries identified as priority coun24 tries— 


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1 (A) a detailed summary of nutrition pro2 grams and activities in the previous fiscal year, 

3 including— 

4 (i) a breakdown of the countries to 

5 which nutrition resources have been allo6 cated; and 

7 (ii) the estimated number of people 

8 reached through nutrition interventions; 

9 and 

10 (B) an assessment of the coordination of 

11 nutrition programs with other health and devel12 opment programs and priorities; 

13 (3) a summary of efforts to expand research 

14 and innovation to development and scale up new 

15 tools to prevent and treat global malnutrition; 

16 (4) an assessment of the collaboration and co17 ordination of USAID nutrition efforts with the 

18 United Nations agencies, the World Bank, other 

19 donor governments, host country governments, civil 

20 society, the private sector, and other efforts, as ap21 propriate; 

22 (5) a description of other donor and host coun23 try financial commitments and efforts to prevent 

24 and treat malnutrition; and 


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1 (6) the constraints on implementation of pro2 grams and key lessons learned from programs and 

3 activities from the previous fiscal years. 

4 (b) USE OF INFORMATION.—The Administrator may 

5 choose to include the report required in this section as a 

6 component of other congressionally mandated reports pro7 vided to appropriate congressional committees, as appro8 priate. 

9 SEC. 7. COMPLIANCE WITH THE FOREIGN AID TRANS10 PARENCY AND ACCOUNTABILITY ACT OF 

11 2016. 

12 Section 2(3) of the Foreign Aid Transparency and 

13 Accountability Act of 2016 (Public Law 114–191; 22 

14 U.S.C. 2394c note) is amended— 

15 (1) in subparagraph (C), by striking ‘‘and’’ at 

16 the end; 

17 (2) in subparagraph (D), by striking the period 

18 at the end and inserting ‘‘; and’’; and 

19 (3) by adding at the end the following: 

20 ‘‘(E) the Global Malnutrition Prevention 

21 and Treatment Act of 2021.’’. 


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1 SEC. 8. SUNSET. 

2 This Act shall cease to have force or effect beginning 

3 on the date that is 7 years after the date of the enactment 

4 of this Act. 

Æ 


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