```

[Congressional Bills 117th Congress]
[From the U.S. Government Publishing Office]
[S. 2956 Introduced in Senate (IS)]

<DOC>

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.

    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 ``Global Malnutrition Prevention and 
Treatment Act of 2021''.

SEC. 2. NUTRITION PROGRAMS.

    (a) In General.--The Administrator of the United States Agency for 
International Development, in coordination with relevant Federal 
departments and agencies, is authorized and encouraged to scale up the 
prevention and treatment of global malnutrition, including by 
supporting efforts--
            (1) to target high-impact and evidence-based resources and 
        nutrition interventions to support the most vulnerable 
        populations, including children younger than 5 years of age and 
        pregnant and lactating women, susceptible to severe 
        malnutrition, including both stunting and wasting;
            (2) to increase coverage, particularly within priority 
        countries, of high-impact and evidence-based nutrition 
        interventions that include coordinated deployment of prenatal 
        vitamins, breastfeeding support, vitamin A supplementation, 
        emergency therapeutic food, and other evidence-based 
        interventions as appropriate;
            (3) to increase the use of context and country-appropriate 
        fortification of staples and condiments with essential 
        nutrients;
            (4) to advance evidence-based programs and interventions 
        carried out using data-driven approaches, best practices, and 
        targeted to country-specific contexts and needs;
            (5) to support the development of country-specific policies 
        to prevent and treat malnutrition;
            (6) to leverage investments to strengthen primary health 
        systems and support community health workers in order to 
        advance improved nutrition outcomes; and
            (7) to ensure rigorous monitoring and evaluation of all 
        nutrition programs and interventions.
    (b) Coordination.--The Administrator of the United States Agency 
for International Development, in coordination with relevant Federal 
departments and agencies, should coordinate with bilateral and 
multilateral donors, partner country governments, United Nations 
agencies, civil society, nongovernmental organizations, including 
faith-based organizations, and the private sector to scale up efforts 
to prevent and treat global malnutrition, including by--
            (1) building the capacity of local and community-based 
        organizations and partner country governments to expand 
        coverage and ensure sustainability of nutrition interventions;
            (2) expanding research and innovation to identify and scale 
        effective and evidence-based nutrition interventions based on 
        country-specific contexts;
            (3) improving the coordination of nutrition interventions, 
        including within the United Nations;
            (4) leveraging additional resources and ensuring 
        appropriate burden-sharing to support nutrition interventions 
        in priority countries;
            (5) expanding domestic resource mobilization and domestic 
        financing for nutrition interventions; and
            (6) encouraging investment into innovative and 
        multistakeholder finance partnerships.

SEC. 3. PRIORITY COUNTRIES.

    (a) Designation.--The Administrator, in coordination with the 
Nutrition Leadership Council, shall--
            (1) designate certain countries as ``priority countries'' 
        for the purposes of prioritizing programs to prevent and treat 
        malnutrition; and
            (2) not later than 5 years after the date of the enactment 
        of this Act, review and update such designations based on the 
        criteria described in subsection (b).
    (b) Criteria.--In selecting priority countries under subsection 
(a), the Administrator should consider--
            (1) the prevalence of severe malnutrition among children 
        younger than 5 years of age and pregnant and lactating women;
            (2) the presence of high-need, underserved, marginalized, 
        vulnerable, or impoverished communities;
            (3) the enabling environment for improved nutrition, 
        including the presence of national nutrition plans and the 
        demonstration of strong political commitment; and
            (4) other appropriate factors.
    (c) Sense of Congress.--It is the sense of Congress that the 
Administrator should continue to undertake nutrition interventions in 
countries that are not selected as priority countries, particularly if 
opportunities are identified to advance multi-sectoral development 
programming and to integrate efforts to prevent and treat global 
malnutrition with other priority areas and program objectives.

SEC. 4. COORDINATION.

    (a) Nutrition Leadership Council.--There is established at the 
United States Agency for International Development (referred to in this 
section as ``USAID''), the Nutrition Leadership Council (referred to in 
this section as the ``Council''), which shall coordinate efforts by 
USAID to prevent and treat malnutrition globally.
    (b) Duties.--The Council shall--
            (1) advance efforts by USAID to prevent and treat 
        malnutrition globally;
            (2) ensure that nutrition interventions, particularly 
        within priority countries, are carried out in close 
        coordination with and aligned with existing United States 
        Government and USAID strategies, including--
                    (A) the Senator Paul Simon Water for the World Act 
                of 2014 (Public Law 113-289);
                    (B) the Global Food Security Act of 2016 (22 U.S.C. 
                9301 et seq.);
                    (C) the Global Fragility Act of 2019 (22 U.S.C. 
                9801 et seq.); and
                    (D) the Global Child Thrive Act of 2020 (subtitle I 
                of title XII of division A of Public Law 116-283); and
            (3) ensure that nutrition programs and interventions are 
        coordinated with nutrition programs carried out by other 
        relevant Federal departments and agencies.
    (c) Membership.--The Council shall include representatives of--
            (1) the Bureau for Global Health;
            (2) the Bureau for Resilience and Food Security;
            (3) the Bureau for Humanitarian Assistance; and
            (4) other appropriate USAID bureaus and offices.
    (d) Interagency Efforts.--In carrying out the activities described 
in section 2, the Administrator, in coordination with relevant Federal 
departments and agencies, shall seek to leverage additional private 
sector resources to prevent and treat malnutrition in priority 
countries by--
            (1) increasing cooperation between USAID, the Millennium 
        Challenge Corporation, the United States International 
        Development Finance Corporation, and other relevant Federal 
        departments and agencies to better leverage the full spectrum 
        of grants, technical assistance, debt, equity, loan guaranty 
        tools, and public-private partnerships to prevent and treat 
        global malnutrition;
            (2) utilizing the Administrator's role as Development 
        Finance Corporation Vice Chair to consider opportunities within 
        the Development Finance Corporation's development impact 
        framework that support improved nutrition outcomes; and
            (3) exploring opportunities to advance burden-sharing in 
        nutrition-related assistance.

SEC. 5. IMPLEMENTATION PLAN.

    (a) In General.--Not later than 260 days after the date of the 
enactment of this Act, the Administrator, in coordination with other 
relevant Federal departments and agencies, shall develop and submit to 
the appropriate congressional committees an implementation plan to 
prevent and treat global malnutrition and carry out the activities 
authorized under section 2.
    (b) Contents.--The implementation plan required under subsection 
(a) shall--
            (1) establish specific and measurable goals, objectives, 
        and performance metrics towards prevention and treatment of 
        global malnutrition, including clear benchmarks and intended 
        timelines for achieving such goals and objectives;
            (2) establish baseline measurements and time-bound targets 
        for increasing coverage of key nutrition interventions in 
        priority countries, which may include scaling up to--
                    (A) 80-percent coverage for--
                            (i) vitamin A (to be measured by the 
                        proportion of children 6 to 59 months old 
                        receiving 2 high-dose vitamin A supplements in 
                        a given year);
                            (ii) prenatal vitamins (measured by the 
                        proportion of pregnant women who received 
                        multiple micronutrient supplementation daily); 
                        and
                            (iii) breastfeeding (as measured by 
                        proportion of mothers of children between 0 and 
                        5 months of age reached by promotion of 
                        breastfeeding activities); and
                    (B) 50-percent coverage for treatment of wasting 
                (as measured by the proportion of children 6 to 59 
                months with severe acute malnutrition receiving 
                therapeutic feeding treatment);
            (3) require monitoring and evaluation plans for all 
        nutrition programs and activities, as appropriate;
            (4) in countries that were selected as priority countries, 
        ensure that nutrition is adequately addressed within the 
        Country Development Cooperation Strategy to the extent 
        practicable and identify opportunities to expand efforts to 
        prevent and treat malnutrition, including through leveraging 
        existing health and development programs and other ongoing 
        activities; and
            (5) require all USAID grants, contracts, and cooperative 
        agreements for the purposes of the treatment or prevention of 
        severe malnutrition to include targets for increased coverage 
        of high-impact nutrition interventions, including the 
        establishment of baseline measurements from which to quantify 
        progress.
    (c) Stakeholder Consultation.--The implementation plan required 
under this section shall be developed in consultation with, as 
appropriate, representatives of nongovernmental organizations, 
including faith-based organizations, civil society groups, multilateral 
organizations and donors, relevant private, academic, and philanthropic 
entities, and the appropriate congressional committees.

SEC. 6. REPORTING REQUIREMENTS.

    (a) Annual Report.--Not later than 1 year after the date of the 
enactment of this Act, and annually thereafter for 5 additional years, 
the Administrator shall submit a report to the appropriate 
congressional committees that describes the progress made towards 
preventing and treating malnutrition, including--
            (1) a summary of the progress made towards achieving the 
        specific and measurable goals, objectives, and performance 
        metrics towards ending global malnutrition identified as 
        required under section 5(b)(1);
            (2) in countries identified as priority countries--
                    (A) a detailed summary of nutrition programs and 
                activities in the previous fiscal year, including--
                            (i) a breakdown of the countries to which 
                        nutrition resources have been allocated; and
                            (ii) the estimated number of people reached 
                        through nutrition interventions; and
                    (B) an assessment of the coordination of nutrition 
                programs with other health and development programs and 
                priorities;
            (3) a summary of efforts to expand research and innovation 
        to development and scale up new tools to prevent and treat 
        global malnutrition;
            (4) an assessment of the collaboration and coordination of 
        USAID nutrition efforts with the United Nations agencies, the 
        World Bank, other donor governments, host country governments, 
        civil society, the private sector, and other efforts, as 
        appropriate;
            (5) a description of other donor and host country financial 
        commitments and efforts to prevent and treat malnutrition; and
            (6) the constraints on implementation of programs and key 
        lessons learned from programs and activities from the previous 
        fiscal years.
    (b) Use of Information.--The Administrator may choose to include 
the report required in this section as a component of other 
congressionally mandated reports provided to appropriate congressional 
committees, as appropriate.

SEC. 7. COMPLIANCE WITH THE FOREIGN AID TRANSPARENCY AND ACCOUNTABILITY 
              ACT OF 2016.

    Section 2(3) of the Foreign Aid Transparency and Accountability Act 
of 2016 (Public Law 114-191; 22 U.S.C. 2394c note) is amended--
            (1) in subparagraph (C), by striking ``and'' at the end;
            (2) in subparagraph (D), by striking the period at the end 
        and inserting ``; and''; and
            (3) by adding at the end the following:
                    ``(E) the Global Malnutrition Prevention and 
                Treatment Act of 2021.''.

SEC. 8. SUNSET.

    This Act shall cease to have force or effect beginning on the date 
that is 7 years after the date of the enactment of this Act.
                                 <all>
```