I

106TH CONGRESS

1ST SESSION H. R. 2028

To authorize appropriations for fiscal year 2000 for infant and child health

programs under chapters 1 and 10 of part I of the Foreign Assistance

Act of 1961, and for other purposes.

IN THE HOUSE OF REPRESENTATIVES

JUNE 7, 1999

Mr. PITTS (for himself, Mr. SMITH of New Jersey, Mr. MCINTOSH, and Mr.

WOLF) introduced the following bill; which was referred to the Committee

on International Relations

A BILL

To authorize appropriations for fiscal year 2000 for infant

and child health programs under chapters 1 and 10

of part I of the Foreign Assistance Act of 1961, 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. FINDINGS.

4 The Congress finds the following:

5 (1) Every year, an estimated 12,000,000 chil6 dren under the age of 5 years die, mostly of easily

7 preventable causes, and about 160,000,000 children
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1 are severely or moderately malnourished throughout

2 the world.

3 (2) Despite significant progress made in child

4 survival efforts, 32,000 children continue to die

5 every day, largely from preventable causes.

6 (3) Of the 12,000,000 children under 5 who die

7 each year from preventable causes, 6,000,000 die di8 rectly or indirectly from malnutrition.

9 (4) The under-5 mortality rate (171 per 1,000

10 live births) in the least developed countries is nearly

11 25 times that of the industrialized nations.

12 (5) Diarrheal dehydration remains one of the

13 world’s most widespread child killers, claiming over

14 2,000,000 children under the age of 5 each year in

15 developing countries, and for just 7 cents per dose

16 per child, oral rehydration therapy and continued

17 feeding (ORT), a simple, cost-effective treatment

18 given at home, could prevent as many as 90 percent

19 of all child deaths from diarrheal diseases.

20 (6) Although 80 percent of children are now

21 being vaccinated against the 6 major killer diseases

22 (measles, tetanus, whooping cough, tuberculosis,

23 polio, and diphtheria), 2,000,000 children are still

24 dying from these diseases each year. Only

25 $30,000,000 ($15 per child) would provide vaccines,
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1 syringes, needles, cold chain equipment, and health

2 workers’ training and salaries needed to immunize

3 2,000,000 children against these 6 major childhood

4 diseases.

5 (7) Malaria kills more than 1,000,000 children

6 under the age of 5 each year, or 1 child every 30

7 seconds, but for less than $15,000,000, all of these

8 children could be provided bed nets to help protect

9 them from this deadly disease.

10 (8) An estimated 2,900,000,000 people lack ac11 cess to adequate sanitation, up from 2,600,000,000

12 in 1990, and without a stronger commitment to

13 sanitation, it will be difficult to reduce the incidence

14 of diarrhea, a leading child killer, and other diseases

15 that flourish in unsanitary conditions. For only

16 $5.50, 1 plastic latrine pan and outlet pipe could

17 provide safe sanitation for 1 family, and for $150,

18 a handpump, pipe, and accessories for equipping a

19 shallow well could benefit up to 250 people.

20 (9) 2,200,000 children under the age of 5 die

21 each year in developing countries of acute res22 piratory infections (ARI). Appropriate treatment of

23 ARI, including early diagnosis and the proper use of

24 antibiotics, could avert 30 to 60 percent of ARI-re25 lated child deaths.
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1 (10) About 100,000,000 children under the age

2 of 5 suffer from vitamin A deficiency, which impairs

3 children’s ability to resist illnesses and contributes

4 to nearly 25 percent of under-5 deaths in developing

5 countries, but 6 cents can buy 3 vitamin A capsules

6 to protect a child against blindness and other health

7 risks from vitamin A deficiency for 1 year, or

8 $6,000,000 could protect 100,000,000 children an9 nually against such blindness and other health risks.

10 (11) Because a major global immunization cam11 paign is nearing the goal of eradicating polio, a 10-

12 year effort to eradicate polio through childhood vac13 cination and surveillance would cost only

14 $100,000,000 per year.

15 (12) Up to 1,500,000 children annually could

16 be saved by increased breast-feeding because breast17 fed infants are up to 25 times less likely to die of

18 diarrheal disease, and 4 times less likely to die of

19 acute respiratory infections.

20 (13) Nevertheless, estimates that each year

21 more than 540,000 infants are infected by Mother

22 To Child Transmission (MTCT) of the HIV virus in

23 Africa alone indicate the urgent need for safe and

24 practical alternatives to breast-feeding by nursing
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1 mothers who are HIV-positive to help prevent the

2 transmission of the virus to their babies.

3 SEC. 2. AUTHORIZATION OF APPROPRIATIONS FOR CHILD

4 SURVIVAL PROGRAMS.

5 (a) AUTHORIZATION OF APPROPRIATIONS.—

6 (1) IN GENERAL.—There is authorized to be

7 appropriated for fiscal year 2000 $345,000,000 for

8 infant and child health programs under chapters 1

9 and 10 of part I of the Foreign Assistance Act of

10 1961 (22 U.S.C. 2151 and 2293 et seq.) that have

11 a direct, measurable, and high impact on reducing

12 the incidence of illness and death among children.

13 (2) ADDITIONAL REQUIREMENT.—Of the

14 amount appropriated pursuant to the authorization

15 of appropriations under paragraph (1), not less than

16 25 percent of such amount shall be allocated for pro17 grams of United States-based, citizen-supported, pri18 vate voluntary organizations that implement commu19 nity-based programs.

20 (b) LIMITATION ON POPULATION PLANNING ASSIST21 ANCE.—Notwithstanding any other provision of law, not

22 more than $285,000,000 of the amounts appropriated in

23 title II of the Foreign Operations, Export Financing, and

24 Related Programs Appropriations Act, 2000, to carry out

25 any of the provisions of law described in such title may
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1 obligated or expended for population planning activities or

2 other population assistance, including all programs and

3 activities designed to control fertility or to reduce or delay

4 childbirths or pregnancies.

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