II

105TH CONGRESS

1ST SESSION S. 1050

To assist in implementing the Plan of Action adopted by the World Summit

for Children.

IN THE SENATE OF THE UNITED STATES

JULY 22, 1997

Mr. JEFFORDS (for himself, Mrs. MURRAY, and Ms. SNOWE) introduced the

following bill; which was read twice and referred to the Committee on

Foreign Relations

A BILL

To assist in implementing the Plan of Action adopted by

the World Summit for Children.

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 ‘‘James P. Grant World

5 Summit for Children Implementation Act of 1997’’.

6 SEC. 2. FINDINGS AND PURPOSES.

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

8 (1) The World Summit for Children held in

9 1990 in New York, the largest gathering of heads of

10 state and heads of government up until that time,
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1 united the world in a commitment to protect the

2 lives of children, diminish their suffering, and en3 hance their futures.

4 (2) This commitment is reflected in specific

5 goals set forth in the Declaration and Plan of Action

6 of the 1990 World Summit for Children that require

7 international cooperation and the commitment of all

8 nations, goals which were endorsed in the World

9 Declaration on Nutrition adopted at the 1992 Inter10 national Conference on Nutrition and endorsed at

11 the 1994 Summit of the Americas, and at the 1995

12 World Summit on Social Development.

13 (3) The United Nations Children’s Fund

14 (UNICEF) estimates that these goals could be im15 plemented by the year 2000 with a global commit16 ment of an additional $40,000,000,000 annually, to

17 be achieved through reallocation of resources to in18 crease the proportion of resources going to meet

19 basic human needs, with two-thirds of those re20 sources coming from the developing nations them21 selves and one-third from the industrialized nations.

22 (4) In 1996 UNICEF estimated that on aver23 age only about 13 percent of developing country

24 budgets and only 10 percent of overseas development

25 assistance by donor nations was devoted to meeting
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1 basic human needs, as defined by the United Na2 tions Development Program, UNICEF, and others.

3 (5) If that proportion of developing country

4 budgets and international development assistance

5 devoted to basic needs were increased to just 20 per6 cent, through reallocation of current resources, this

7 would provide most of the resources UNICEF esti8 mates are required annually to achieve by the year

9 2000 the goals of the World Summit for Children.

10 (6) The United States share of these resources

11 can be realized, without an overall increase in the

12 foreign assistance budget, by increasing the percent13 age of United States bilateral development assist14 ance to at least 20 percent of the total United

15 States foreign assistance budget.

16 (7) The United States Government participated

17 in the World Summit for Children and signed the

18 Declaration and Plan of Action adopted at that

19 Summit.

20 (8) Participants in the Summit committed

21 themselves and their governments to take steps to

22 ensure that child survival, protection, and develop23 ment programs will have a high priority in the allo24 cation of resources.
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1 (9) The United States Government should im2 plement a plan of action to fulfill its commitment to

3 children, both at home and abroad.

4 (10) Public Law 103–227, enacted in 1994 as

5 the ‘‘Goals 2000: Educate America Act’’, outlined

6 United States national goals for education for the

7 rest of the 20th century and beyond. The eight goals

8 outlined by the Act are:

9 (A) SCHOOL READINESS.—By the year

10 2000, all children in America will start school

11 ready to learn.

12 (B) SCHOOL COMPLETION.—By the year

13 2000, the high school graduation rate will in14 crease to at least 90 percent.

15 (C) STUDENT ACHIEVEMENT AND CITIZEN16 SHIP.—By the year 2000, all students will leave

17 grades 4, 8, and 12 having demonstrated com18 petency over challenging subject matter includ19 ing English, mathematics, science, foreign lan20 guages, civics and government, economics, arts,

21 history, and geography, and every school in

22 America will ensure that all students learn to

23 use their minds well, so they may be prepared

24 for responsible citizenship, further learning, and
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1 productive employment in our Nation’s modern

2 economy.

3 (D) TEACHER EDUCATION AND PROFES4 SIONAL DEVELOPMENT.—By the year 2000, the

5 Nation’s teaching force will have access to pro6 grams for the continued improvement of their

7 professional skills and the opportunity to ac8 quire the knowledge and skills needed to in9 struct and prepare all American students for

10 the next century.

11 (E) MATHEMATICS AND SCIENCE.—By the

12 year 2000, United States students will be first

13 in the world in mathematics and science

14 achievement.

15 (F) ADULT LITERACY AND LIFELONG

16 LEARNING.—By the year 2000, every adult

17 American will be literate and will possess the

18 knowledge and skills necessary to compete in a

19 global economy and exercise the rights and re20 sponsibilities of citizenship.

21 (G) SAFE, DISCIPLINED, AND ALCOHOL22 AND DRUG-FREE SCHOOLS.—By the year 2000,

23 every school in the United States will be free of

24 drugs, violence, and unauthorized presence of
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1 firearms and alcohol and will offer a disciplined

2 environment conducive to learning.

3 (H) PARENTAL PARTICIPATION.—By the

4 year 2000, every school will promote partner5 ships that will increase parental involvement

6 and participation in promoting the social, emo7 tional, and academic growth of children.

8 (11) Achievement of the National Education

9 Goals contained in paragraph (10) will contribute to

10 implementation by the United States of the plan of

11 action.

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

13 (1) to help define a plan of action to fulfill the

14 commitment of the United States Government to

15 children; and

16 (2) to provide the necessary authorities to im17 plement that plan of action.

18 SEC. 3. SPECIAL SUPPLEMENTAL FOOD PROGRAM FOR

19 WOMEN, INFANTS AND CHILDREN (WIC).

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

21 (1) In 1990, the Surgeon General and the Unit22 ed States Public Health Service announced Healthy

23 People 2000 goals for America’s children. These

24 goals include reducing the infant mortality rate and
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1 the incidence of low birth weight in the United

2 States by one-third by the year 2000.

3 (2) The Special Supplemental Food Program

4 for Women, Infants and Children authorized under

5 section 17 of the Child Nutrition Act of 1966 (in

6 this section referred to as the ‘‘WIC Program’’) is

7 intended to benefit low-income infants and children

8 at risk to be born at low birthweight (a proven cause

9 of mental retardation) and who have a mortality

10 rate at least twice as high as infants and children

11 from higher income families.

12 (3) It has been demonstrated that participation

13 in the WIC Program reduces, in a cost-effective

14 manner, the infant mortality rate, the number of

15 premature births, and the percentage of infants born

16 at low birthweight or with development disabilities.

17 (b) FUNDING FOR FISCAL YEAR 1998 AND 1999.—

18 It is the sense of Congress that not less than

19 $4,008,000,000 for fiscal year 1998 and not less than

20 $4,140,000,000 for the fiscal year 1999 should be appro21 priated to carry out the WIC Program.

22 SEC. 4. PROGRAMS UNDER THE HEAD START ACT.

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

24 (1) In 1990, the President and the Governors

25 of the 50 States met at the Education Summit and
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1 set United States education goals for the year 2000.

2 Among these goals, which were subsequently incor3 porated in the 1994 Educate America Act (Public

4 Law 103–227), was that all children in America

5 would start school ready to learn.

6 (2) Since their inception in 1964, programs

7 under the Head Start Act have established an im8 pressive record in providing preschool-age children

9 from low-income families with comprehensive serv10 ices to address educational, social, nutritional, and

11 health needs.

12 (3) Head Start programs are currently able to

13 serve only about 35 to 40 percent of eligible children

14 between 3 and 5 years of age.

15 (b) FUNDING FOR FISCAL YEAR 1998 AND 1999.—

16 It is the sense of Congress that not less than

17 $4,305,500,000 for fiscal year 1998 and not less than

18 $4,901,000,000 for fiscal year 1999 should be appro19 priated for programs under the Head Start Act.

20 SEC. 5. INTERNATIONAL INFANT AND CHILD MORTALITY.

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

22 (1) Since the 1980s, the international campaign

23 to save the lives of children has resulted in dramatic

24 increases in the adoption of low-cost measures, such

25 as immunizations and oral rehydration therapy,
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1 which have saved the lives of over 20,000,000

2 children.

3 (2) In September 1991, the United Nations

4 Children’s Fund and the World Health Organization

5 were able to report that the goal of 80 percent uni6 versal childhood immunization had been achieved.

7 (3) The Plan of Action adopted by the World

8 Summit for Children calls for the reduction of

9 under-5 mortality rates by at least one-third by the

10 year 2000, and halving moderate and severe mal11 nutrition among children under 5.

12 (4) Such progress will be possible with a contin13 ued focus on child survival activities that utilize sim14 ple, available technologies that have proven to be di15 rectly effective in saving children’s lives, and with a

16 particular focus on assistance to countries and re17 gions with the highest rates of child mortality.

18 (5) Both UNICEF and the United States

19 Agency for International Development have provided

20 strong leadership as well as financial and technical

21 support for these goals.

22 (b) CONTRIBUTIONS TO UNICEF.—To carry out sec23 tion 301 of the Foreign Assistance Act of 1961 (22 U.S.C.

24 2221; relating to voluntary contributions to international

25 organizations and programs), there are authorized to be
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1 appropriated $100,000,000 for fiscal year 1998, and

2 $105,000,000 for fiscal year 1999 for contributions to the

3 United Nations Children’s Fund (UNICEF) for activities

4 to promote child health and other assistance programs on

5 behalf of children.

6 (c) CHILD SURVIVAL ACTIVITIES.—Section 104(c)(2)

7 of the Foreign Assistance Act of 1961 (22 U.S.C.

8 2151b(c)(2)) (relating to the Child Survival Fund) is

9 amended—

10 (1) by inserting after subparagraph (C) the fol11 lowing new subparagraphs:

12 ‘‘(D)(i) Subject to clause (ii), of the aggre13 gate of the amounts made available to carry out

14 subparagraph (B), section 103(a), and section

15 106, chapter 10 of this part, and chapter 4 of

16 part II and for the Multilateral Assistance Ini17 tiative for the Philippines, not less than

18 $350,000,000 for fiscal year 1998 and not less

19 than $380,000,000 for fiscal year 1999 shall be

20 available only for activities that—

21 ‘‘(I) have a direct, measurable impact

22 on the reduction in the rates of child death

23 and disease, with a particular emphasis on

24 delivery of community-based primary
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1 health care and health education services

2 in the poorest communities;

3 ‘‘(II) are primarily limited to the di4 rect provision of basic health services such

5 as improved and expanded immunization

6 programs, oral rehydration to combat

7 diarrhoeal disease, treatment of acute res8 piratory infection, and health education

9 programs aimed at improving nutrition

10 and sanitation and at promoting child

11 spacing; and

12 ‘‘(III) utilize simple technologies of

13 the kind described in subparagraph (A).

14 ‘‘(ii) Amounts made available under section

15 103(h) (relating to the Vitamin A Deficiency

16 Program), part I of this Act for iodine and iron

17 fortification programs and for iron

18 supplementation programs for pregnant women,

19 chapter 9 of this part (relating to international

20 disaster assistance), section 104(c)(4) (relating

21 to international AIDS prevention and control),

22 and any other provision of law for migration

23 and refugee assistance shall not be available for

24 the purposes of clause (i).
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1 ‘‘(E)(i) The President shall include in the

2 annual budget submitted to the Congress pur3 suant to section 1105 of title 31, United States

4 Code—

5 ‘‘(I) an estimate of the impact of each

6 program, project, or activity to be carried

7 out under subparagraph (D)(i), and under

8 the vitamin A and micronutrient deficiency

9 program, on the rates of child death and

10 disease; and

11 ‘‘(II) an assessment of the actual im12 pact on the rates of child death and dis13 ease of each program completed in the pre14 vious year.

15 ‘‘(ii) In preparing such estimates the

16 President may make use of data on intermedi17 ate measures such as immunization coverage

18 rates and prevalence of oral rehydration use.’’.

19 SEC. 6. GLOBAL MALNUTRITION.

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

21 (1) Malnutrition is a preventable, underlying

22 cause of a high proportion of child deaths.

23 (2) The Plan of Action adopted at the World

24 Summit for Children calls for reducing by 50 per-
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1 cent severe and moderate malnutrition among chil2 dren under 5 years of age by the year 2000.

3 (3) The Congress has already undertaken sub4 stantial action to address this problem in the Food,

5 Agriculture, Conservation, and Trade Act of 1990,

6 which established food security for the poorest and

7 the prevention of malnutrition as priorities in food

8 assistance programs administered by the United

9 States Agency for International Development under

10 the Agriculture Trade Development and Assistance

11 Act of 1954.

12 (4) Section 411 of the Agricultural Trade De13 velopment and Assistance Act of 1954 (7 U.S.C.

14 1736e), as amended by the Food, Agriculture, Con15 servation, and Trade Act of 1990, authorizes the

16 forgiveness of Public Law 480 debt owed by least

17 developed countries that are pursuing national eco18 nomic policy reforms that would promote long-term

19 economic development, but the exercise of that au20 thority requires further action by Congress in an ap21 propriations Act.

22 (5) Child Survival activities provide an effective,

23 integrated approach to battling the complex problem

24 of childhood malnutrition leading to mortality and
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1 must be pursued alongside efforts to ensure food

2 security.

3 (6)(A) Vitamin A deficiency is a scourge of ap4 proximately a quarter of a billion children in devel5 oping countries.

6 (B) Research financed by the United States

7 Agency for International Development and other do8 nors has convincingly demonstrated that vitamin A

9 supplementation and fortification can reduce child10 hood mortality by 30 percent or more.

11 (C) An estimated 20,000,000 children are likely

12 to die and 3,500,000 children are likely to go blind

13 in the next decade if access to vitamin A is not

14 available.

15 (D) The World Bank has estimated that vita16 min A supplementation costs only about $9 for every

17 year of life saved, adjusted for disability.

18 (E) A single capsule of Vitamin A costs only

19 five cents.

20 (7) Preventing key micronutrient deficiencies of

21 vitamin A, iodine, iron, and zinc is a low-cost, prac22 tical, and effective approach to building human ca23 pacity, quality of life, and protecting the future for

24 billions of people throughout the world.
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1 (8)(A) Today 1,600,000,000 people are at risk

2 of iodine deficiency disorders, with the fetus and in3 fant being the most vulnerable to permanent brain

4 damage.

5 (B) Iodine deficiency is the most prevalent

6 cause of preventable mental retardation worldwide.

7 (C) Iodizing salt can go far in preventing this

8 tragedy and therefore will enhance the intellectual

9 and economic performance of future generations.

10 (D) The World Bank estimates that it costs

11 only $8 for every year of life saved, adjusted for dis12 ability.

13 (9)(A) Nearly 2,000,000,000 people are iron14 deficient, particularly women of child-bearing age

15 and young children, approximately 1,000,000,000 of

16 whom suffer from anemia.

17 (B) Iron deficiency anemia during pregnancy

18 can increase the risk of both maternal and infant

19 mortality.

20 (C) Moreover, iron deficiency can hinder learn21 ing among school-age children and work productivity

22 among adults.

23 (D) The World Bank has estimated that iron

24 supplementation costs only $4 to $13 for every year

25 of life saved, adjusted for disability.
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1 (10) Vitamin A and iodine deficiencies could be

2 virtually eliminated, and iron deficiency anemia re3 duced by one-third, by the first decade of the 21st

4 century.

5 (b) PUBLIC LAW 480 DEBT FORGIVENESS.—It is the

6 sense of Congress that authority, in such amounts as may

7 be required, should be granted to the President in an ap8 propriations Act to provide the debt relief for least devel9 oped countries that is provided in section 411 of the Agri10 cultural Trade Development and Assistance Act of 1954.

11 (c) VITAMIN A DEFICIENCY PROGRAM.—Section 103

12 of the Foreign Assistance Act of 1961 (22 U.S.C. 2151a;

13 relating to development assistance for agriculture, rural

14 development, and nutrition) is amended by adding at the

15 end the following new subsection:

16 ‘‘(h) VITAMIN A DEFICIENCY PROGRAM.—Of the

17 amounts made available to carry out this section, not less

18 than $17,000,000 for fiscal year 1998 and not less than

19 $20,000,000 for fiscal year 1999 shall be available only

20 for implementing Vitamin A deficiency prevention strate21 gies, especially supplementation and fortification

22 programs.’’.

23 (d) OTHER MICRONUTRIENT DEFICIENCIES.—In ad24 dition to amounts otherwise available for such programs,

25 there are authorized to be appropriated to the President
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1 $13,000,000 for fiscal year 1998 and $15,000,000 for fis2 cal year 1999 for iodine and iron deficiency prevention

3 programs under the Foreign Assistance Act of 1961, espe4 cially fortification and supplementation programs, with

5 particular emphasis on alleviating deficiencies in pregnant

6 women.

7 SEC. 7. MATERNAL AND CHILD MORTALITY RESULTING

8 FROM AIDS.

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

10 (1) Three million people worldwide became

11 newly infected with HIV in 1996, bringing the total

12 number of infections since the beginning of the pan13 demic to nearly 30,000,000.

14 (2) The Joint United Nations Programme on

15 HIV/AIDS (UNAIDS) and the World Health Orga16 nization (WHO) estimate that by the year 2000

17 more than 40,000,000 people will have become in18 fected with HIV. Ninety percent of these infections

19 are occurring in the developing world.

20 (3) One-half of all new infections occur among

21 women, especially those under the age of 25.

22 (4) The maternal and child mortality rate in

23 many developing countries will increase dramatically

24 until HIV/AIDS prevention and control efforts are
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1 successful, as will the number of orphans with HIV/

2 AIDS.

3 (5) The most effective efforts to respond to

4 HIV/AIDS are based at the community level and in5 volve nongovernmental organizations as well as gov6 ernment agencies.

7 (6) The United States Agency for International

8 Development should expand its assistance to devel9 oping countries for community-based prevention,

10 care, and control programs and activities relating to

11 HIV/AIDS, and should participate in coordinated ef12 forts with other donors.

13 (7) Coordination of efforts of bilateral, multilat14 eral and nongovernmental agencies and organiza15 tions is essential.

16 (b) INTERNATIONAL AIDS PREVENTION AND CON17 TROL FUND.—Section 104(c) of the Foreign Assistance

18 Act of 1961 (22 U.S.C. 2151b(c); relating to development

19 assistance for health related activities) is amended by add20 ing at the end the following new paragraph:

21 ‘‘(3)(A) In carrying out this subsection, the

22 President shall promote, encourage, and undertake

23 community-based prevention and control programs

24 and activities relating to the human
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1 immunodeficiency virus (HIV) and acquired immune

2 deficiency syndrome (AIDS) in developing countries.

3 ‘‘(B) There are authorized to be appropriated

4 $140,000,000 for fiscal year 1998 and

5 $150,000,000 for fiscal year 1999 for use in carry6 ing out this paragraph, which shall be in addition to

7 amounts made available under subsection (g) or oth8 erwise available for such purpose. Amounts appro9 priated under this subparagraph are authorized to

10 remain available until expended.

11 ‘‘(C) Appropriations pursuant to subparagraph

12 (B) may be referred to as the ‘International AIDS

13 Prevention and Control Fund’.’’

14 SEC. 8. INTERNATIONAL BASIC EDUCATION.

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

16 (1) Primary education, early childhood develop17 ment activities, and programs to achieve literacy, are

18 essential for increasing the productive capacity of

19 people and their ability to earn income.

20 (2) Basic education, usually defined as early

21 childhood education, primary and lower secondary

22 schooling, as well as adult literacy has been shown

23 to be one of the most economically productive invest24 ments that can be made.
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1 (3)(A) In addition to direct economic benefits,

2 basic education has numerous beneficial social

3 impacts.

4 (B) Widespread education leads to more equi5 table income distribution and, ultimately, to political

6 stability.

7 (C) Countries in which large numbers of chil8 dren enter secondary school have lower levels of in9 vestment risk, as measured by the World Bank, and

10 higher levels of democratic rights, as measured by

11 the Freedom House Index.

12 (4)(A) More than 130,000,000 school-age chil13 dren, the majority of them girls, are not enrolled in

14 primary school.

15 (B) Basic education, especially basic education

16 for girls, contributes to increased child survival,

17 overall life expectancy, and lower birth rates.

18 (C) Throughout the developing world, women

19 with more education desire smaller families.

20 (D) Education of young women dramatically

21 enhances the survival of the children of such women.

22 (E) It is estimated that every additional year of

23 schooling for girls lowers child death rates by 5 to

24 10 percent.
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1 (5) The Plan of Action adopted by the World

2 Summit for Children calls for basic education for all

3 children and for completion of primary education by

4 at least 80 percent of all children.

5 (6) Although it is clear that investments in edu6 cation are a prerequisite for sustainable develop7 ment, United States assistance for basic education

8 in developing countries has accounted for less than

9 2 percent of United States foreign assistance in re10 cent years.

11 (b) INTERNATIONAL BASIC EDUCATION.—Section

12 105 of the Foreign Assistance Act of 1961 (22 U.S.C.

13 2151c; relating to development assistance for education

14 and human resource development) is amended by adding

15 at the end the following new subsection:

16 ‘‘(c) BASIC EDUCATION.—(1)(A) Of the aggregate

17 amounts made available to carry out this section, chapter

18 10 of this part, and chapter 4 of part II and for the Multi19 lateral Assistance Initiative for the Philippines for fiscal

20 years 1998 and 1999, not less than $120,000,000 for fis21 cal year 1998 and not less than $140,000,000 for fiscal

22 year 1999 shall be available only for programs in support

23 of basic education activities described in subparagraph

24 (B).
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1 ‘‘(B) The basic education activities described in this

2 subparagraph are early childhood education, primary and

3 lower secondary education, and literacy training for

4 adults.

5 ‘‘(C) Amounts made available under this paragraph

6 may be used only for activities which have a direct and

7 measurable impact on primary school enrollment, literacy,

8 or educational attainment.

9 ‘‘(2) The President shall include in the annual budget

10 submitted to Congress pursuant to section 1105 of title

11 31, United States Code, a description of the measured or

12 estimated impact on primary school enrollment, literacy,

13 and educational attainment of each project or program

14 carried out under this subsection.’’.

15 SEC. 9. INTERNATIONAL FAMILY PLANNING AND CHILD

16 SPACING.

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

18 (1) Universal access to voluntary family plan19 ning could save the lives of several million children

20 each year, and could significantly improve the health

21 of children throughout the developing world by re22 ducing prematurity and low birthweight and allowing

23 longer breast feeding.

24 (2) The risk of maternal death or illness in the

25 developing world is highest for women who bear chil-
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1 dren when they are under the age of 18 or over age

2 35, for pregnancies spaced less than 2 years apart,

3 and for women who already have 4 or more children.

4 Universal access to voluntary family planning could

5 prevent up to one-third of the estimated 585,000

6 maternal deaths annually.

7 (3) The inability of couples to plan births de8 creases the quality of women’s lives and undermines

9 their opportunities for education, for earning in10 come, for improving the care of children, and for

11 community activities and personal development.

12 (4) Rapid world population growth, combined

13 with unsustainable patterns of natural resource con14 sumption, has become an urgent economic, social,

15 and environmental problem.

16 (5) The Plan of Action adopted at the 1990

17 World Summit for Children calls for voluntary fam18 ily planning services and education to be made avail19 able to all couples to empower them to prevent un20 wanted pregnancies and births which are ‘‘too many

21 and too close’’ and to women who are ‘‘too young or

22 too old’’.

23 (6) Efforts to reduce child death rates and to

24 lower birthrates are mutually reinforcing because

25 closely spaced pregnancies contribute in important
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1 ways to high child mortality and parents need assur2 ances that their children will survive.

3 (b) AUTHORIZATION OF APPROPRIATIONS.—In addi4 tion to any other amounts made available for such pur5 poses, there are authorized to be appropriated to the

6 President for United States population assistance pro7 grams and activities under part I of the Foreign Assist8 ance Act of 1961 not less than $550,000,000 for fiscal

9 year 1998 and not less than $600,000,000 for fiscal year

10 1999.

11 SEC. 10. REFUGEES.

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

13 (1) In 1997 there are 27,000,000 people of con14 cern in refugee-like situations in areas from North15 ern Iraq, to Angola, to the former Yugoslavia, and

16 in addition, there are estimated to be more than

17 20,000,000 internally displaced persons. A large ma18 jority of these refugees and internally displaced per19 sons are children.

20 (2) The dramatic growth in the number of refu21 gees and displaced persons, has resulted in the in22 creased need for legal assistance and protection,

23 health, nutrition, and basic education services avail24 able to such refugees and displaced persons.
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1 (3) Refugee children are particularly vulnerable

2 in first asylum camps from Africa to Southeast Asia,

3 particularly unaccompanied children who languish

4 without the protection and nurturing of a parent or

5 adult guardian.

6 (4) At least 12 major repatriation programs are

7 currently in operation worldwide and such programs

8 will be successful in promoting regional stability only

9 if adequate funding is appropriated for

10 reintegration.

11 (b) FUNDING FOR REFUGEE ASSISTANCE PRO12 GRAMS.—It is the sense of Congress that—

13 (1) not less than $730,000,000 for fiscal year

14 1998 and $780,000,000 for fiscal year 1999, should

15 be appropriated for the ‘‘Migration and Refugee As16 sistance’’ account, of which not less than

17 $470,000,000 for fiscal year 1998 and

18 $500,000,000 for fiscal year 1999 should be avail19 able only for programs of refugee assistance overseas

20 (in addition to the amounts available for programs

21 for refugees from the former Soviet Union, Eastern

22 Europe, and elsewhere who resettle in Israel); and

23 (2) not less than $100,000,000 for each of the

24 fiscal years 1998 and 1999 should be appropriated
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1 for the ‘‘United States Emergency Refugee and Mi2 gration Assistance Fund’’ account.

3 SEC. 11. TUBERCULOSIS.

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

5 (1) It is estimated that 15,000,000 individuals

6 in the United States are infected with tuberculosis.

7 (2) The threat to the health of Americans with

8 respect to tuberculosis consists of—

9 (A) the global spread of tuberculosis in

10 general, including its resurgence in the United

11 States; and

12 (B) the emergence and spread of strains of

13 tuberculosis that are multidrug resistant.

14 (3)(A) Elimination of tuberculosis in the United

15 States can only be achieved by controlling the dis16 ease in developing countries.

17 (B) Tuberculosis is spreading as a result of in18 adequate treatment, and it is a disease that knows

19 no national borders.

20 (4)(A) Tuberculosis is an infectious disease that

21 kills an estimated 3,000,000 people a year

22 worldwide.

23 (B) Tuberculosis is the largest infectious killer

24 of adults, causing more deaths than AIDS, cholera,
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1 malaria, tetanus, meningitis, and typhoid fever

2 combined.

3 (C) Most cases of tuberculosis and deaths

4 caused by tuberculosis occur among individuals in

5 their most productive years of life.

6 (5)(A) Children bear the brunt of the tuber7 culosis of their parents.

8 (B) No other infectious disease creates as many

9 orphans as tuberculosis.

10 (C) Nearly 170,000 children die of tuberculosis

11 annually, usually because of infection by an adult

12 family member.

13 (D) Children under the age of 2 are especially

14 susceptible to deadly strains of the disease.

15 (E) In addition, children suffer the results of

16 the inability of their parents’ and grandparents’ in17 ability to work and care for their families.

18 (F) In the United States, the number of chil19 dren under age 15 who were sick with tuberculosis

20 increased by 35 percent between 1985 and 1992.

21 (6)(A) The World Health Organization has

22 stated that the best curative method for tuberculosis

23 is known as Directly Observed Treatment (DOT), in

24 which health workers directly monitor patients with
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1 tuberculosis for the purpose of ensuring that such

2 patients take their full course of medicine.

3 (B) By guaranteeing that the treatment regi4 mens are completed, DOT prevents the further

5 spread of infection and development of strains of tu6 berculosis that are multidrug resistant.

7 (7)(A) Few public health expenditures provide

8 so much value for so little money as expenditures for

9 the prevention and treatment of tuberculosis.

10 (B) In some parts of the world, the cost of cur11 ing tuberculosis is as little as 90 cents for every year

12 added to the life of the patient.

13 (C) Drugs for the treatment of tuberculosis cost

14 as little as $11 per person in some parts of the

15 world and such drugs are more than 95 percent

16 effective.

17 (D) According to the World Bank, the control

18 of tuberculosis is among the most cost-effective of all

19 health interventions.

20 (8) In order to control tuberculosis in the Unit21 ed States in a more effective manner, it is also nec22 essary to ensure the effectiveness of tuberculosis

23 control programs worldwide.

24 (9) There is a need for an increased number of

25 trained professionals to set up model programs in
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1 developing countries, as well as a need for drugs,

2 other staff costs, and equipment.

3 (10)(A) In addition to the World Health Orga4 nization through its tuberculosis program, non5 governmental organizations, such as the Inter6 national Union Against Tuberculosis and Lung Dis7 ease have proven expertise in the field.

8 (B) Increased support for such nongovern9 mental partners is critical for the expansion of effec10 tive tuberculosis control programs.

11 (11) Setting aside funding to monitor the inci12 dence and spread of tuberculosis worldwide is crucial

13 to successfully combating the disease.

14 (b) FUNDING FOR THE CONTROL OF TUBER15 CULOSIS.—There are authorized to be appropriated to the

16 President $40,000,000 for fiscal year 1998 and

17 $50,000,000 for fiscal year 1999 for the prevention of the

18 global spread of tuberculosis through the provision in the

19 developing countries of drugs, local staff costs, and staff

20 training and equipment, particularly in those developing

21 countries with the highest incidence of tuberculosis.

22 SEC. 12. EFFORTS BY OTHER COUNTRIES.

23 The President shall call upon foreign governments to

24 provide their share of the resources required to achieve

25 the World Summit for Children goals by the year 2000,
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1 specifically through giving highest priority to increasing

2 the proportion of public expenditures and foreign assist3 ance devoted to priority human needs areas outlined in

4 the Declaration and Plan of Action of the World Summit

5 for Children.

6 SEC. 13. ANNUAL REPORT.

7 (a) REQUIREMENT FOR REPORT.—In order that the

8 Congress and the people of the United States may be fully

9 informed of efforts undertaken by the United States Gov10 ernment to fulfill agreements signed by the United States

11 at the World Summit for Children, the President shall

12 submit a report annually to Congress on United States

13 efforts to achieve the goals of the World Summit for Chil14 dren. Each such report shall include—

15 (1) a discussion of efforts by the United States

16 to achieve those goals both within the United States

17 and in other countries; and

18 (2) a comparative analysis of current and past

19 funding levels and planned funding levels for the

20 next 2 fiscal years.

21 (b) SUBMISSION DATE.—The reports required by this

22 section shall be submitted to Congress not later than Feb23 ruary 1 of each year.

Æ