II 

110TH CONGRESS 

1ST SESSION S. 1418 

To provide assistance to improve the health of newborns, children, and 

mothers in developing countries, and for other purposes. 

IN THE SENATE OF THE UNITED STATES 

MAY 17, 2007 

Mr. DODD (for himself, Mr. BROWN, Mr. SMITH, and Mr. LEAHY) introduced 

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

on Foreign Relations 

A BILL 

To provide assistance to improve the health of newborns, 

children, and mothers in developing countries, 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 ‘‘United States Commit5 ment to Global Child Survival Act of 2007’’. 

6 SEC. 2. FINDINGS AND PURPOSES. 

7 (a) FINDINGS.—Congress makes the following find8 ings: 

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1 (1) In 2000, the United States joined 188 

2 countries in committing to achieve 8 Millennium De3 velopment Goals (MDGs) by 2015, including ‘‘MDG 

4 4’’ and ‘‘MDG 5’’ that aim to reduce the mortality 

rate of children under the age of 5 by 2 5 ⁄3 and maternal mortality rate by 3 6 ⁄4 in developing countries, re7 spectively. 

8 (2) The significant commitment of the United 

9 States to reducing child mortality in the developing 

10 world contributed to a 50-percent reduction in the 

11 mortality rate of children under the age of 5 be12 tween 1960 and 1990, and over the past 20 years, 

13 the United States has invested over $6,000,000,000 

14 in child survival programs run by the United States 

15 Agency for International Development. 

16 (3) According to one of the world’s leading 

17 medical journals, the Lancet, despite United States 

18 and global efforts to achieve MDG 4, of the 60 

19 countries that account for 94 percent of under-5 

20 child deaths, ‘‘only seven countries are on track to 

21 meet MDG 4, thirty-nine countries are making some 

22 progress, although they need to accelerate the speed, 

23 and fourteen countries are cause for serious con24 cern’’. 

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1 (4) 10,500,000 children under the age of 5 die 

2 annually, over 29,000 children per day, from easily 

3 preventable and treatable causes, including 

4 4,000,000 newborns who die in the first 4 weeks of 

5 life. 

6 (5) 3,000,000 children die each year due to lack 

7 of access to low-cost antibiotics and antimalarial 

8 drugs, and 1,700,000 die from diseases for which 

9 vaccines are readily available. 

10 (6) Maternal health is an important deter11 minant of neonatal survival with maternal death in12 creasing death rates for newborns to as high as 100 

13 percent in certain countries in the developing world. 

14 (7) Approximately 525,000 women die every 

15 year in the developing world from causes related to 

16 pregnancy and childbirth. 

17 (8) Risk factors for maternal death in devel18 oping countries include pregnancy and childbirth at 

19 an early age, closely spaced births, infectious dis20 eases, malnutrition, and complications during child21 birth. 

(9) According to the Lancet, nearly 2 22 ⁄3 of an23 nual child and newborn deaths, 6,000,000 children, 

24 can be avoided in accordance with MDG 4 if a pack25 age of high impact, low-cost interventions were made 

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1 available at a total, additional, annual cost of 

2 $5,100,000,000, including oral rehydration therapy 

3 for diarrhea ($0.06 per treatment) and antibiotics to 

4 treat respiratory infections ($0.25 per treatment). 

5 (10) 2,000,000 lives could be saved annually by 

6 providing oral rehydration therapy prepared with 

7 clean water. 

8 (11) Exclusive breastfeeding—giving only 

9 breast milk for the first 6 months of life—could pre10 vent an estimated 1,300,000 newborn and infant 

11 deaths each year, primarily by protecting against di12 arrhea and pneumonia. 

13 (12) Expansion of clinical care for newborns 

14 and mothers, such as clean delivery by skilled at15 tendants, emergency obstetric care, and neonatal re16 suscitation, can avert 50 percent of newborn deaths 

17 and reduce maternal mortality. 

18 (13) The United Nations Children’s Fund 

19 (UNICEF), with support from the World Health Or20 ganization, the World Bank, and the African Union, 

21 has successfully demonstrated the accelerated child 

22 survival and development program in Senegal, Mali, 

23 Benin, and Ghana, reducing mortality of children 

24 under the age of 5 by 20 percent in targeted areas 

25 using low-cost, high-impact interventions. 

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1 (14) On September 14, 2005, President George 

2 W. Bush stated before the United Nations High3 Level Plenary Meeting that the United States is 

4 ‘‘committed to the Millennium Development Goals’’. 

5 (15) Nearing the halfway point of attaining the 

6 MDGs by 2015 with thousands of avoidable new7 born, child, and maternal deaths still occurring, the 

8 United States must immediately scale up its funding 

9 and delivery of proven low-cost, life-saving interven10 tions in order to fulfill its commitment to help en11 sure that MDGs 4 and 5 are met. 

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

13 (1) to develop a strategy to reduce mortality 

14 and improve the health of newborns, children, and 

15 mothers, and authorize assistance for its implemen16 tation; and 

17 (2) to establish a task force to assess, monitor, 

18 and evaluate the progress and contributions of rel19 evant departments and agencies of the United States 

20 Government in achieving MDGs 4 and 5. 

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1 SEC. 3. ASSISTANCE TO IMPROVE THE HEALTH OF 

2 NEWBORNS, CHILDREN, AND MOTHERS IN 

3 DEVELOPING COUNTRIES. 

4 (a) IN GENERAL.—Chapter 1 of part I of the Foreign 

5 Assistance Act of 1961 (22 U.S.C. 2151 et seq.) is amend6 ed— 

7 (1) in section 104(c)— 

8 (A) by striking paragraphs (2) and (3); 

9 and 

10 (B) by redesignating paragraph (4) as 

11 paragraph (2); and 

12 (2) by inserting after section 104C the fol13 lowing new section: 

14 ‘‘SEC. 104D. ASSISTANCE TO REDUCE MORTALITY AND IM15 PROVE THE HEALTH OF NEWBORNS, CHIL16 DREN, AND MOTHERS. 

17 ‘‘(a) AUTHORIZATION.—Consistent with section 

18 104(c), the President is authorized to furnish assistance, 

19 on such terms and conditions as the President may deter20 mine, to reduce mortality and improve the health of 

21 newborns, children, and mothers in developing countries. 

22 ‘‘(b) ACTIVITIES SUPPORTED.—Assistance provided 

23 under subsection (a) shall, to the maximum extent prac24 ticable, be used to carry out the following activities: 

25 ‘‘(1) Activities to improve newborn care and 

26 treatment. 

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1 ‘‘(2) Activities to treat childhood illness, includ2 ing increasing access to appropriate treatment for 

3 diarrhea, pneumonia, and other life-threatening 

4 childhood illnesses. 

5 ‘‘(3) Activities to improve child and maternal 

6 nutrition, including the delivery of iron, zinc, vita7 min A, iodine, and other key micronutrients and the 

8 promotion of breastfeeding. 

9 ‘‘(4) Activities to strengthen the delivery of im10 munization services, including efforts to eliminate 

11 polio. 

12 ‘‘(5) Activities to improve birth preparedness 

13 and maternity services. 

14 ‘‘(6) Activities to improve the recognition and 

15 treatment of obstetric complications and disabilities. 

16 ‘‘(7) Activities to improve household-level be17 havior related to safe water, hygiene, exposure to in18 door smoke, and environmental toxins such as lead. 

19 ‘‘(8) Activities to improve capacity for health 

20 governance, health finance, and the health work21 force, including support for training clinicians, 

22 nurses, technicians, sanitation and public health 

23 workers, community-based health works, midwives, 

24 birth attendants, peer educators, volunteers, and pri25 vate sector enterprises. 

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1 ‘‘(9) Activities to address antimicrobial resist2 ance in child and maternal health. 

3 ‘‘(10) Activities to establish and support the 

4 management information systems of host country in5 stitutions and the development and use of tools and 

6 models to collect, analyze, and disseminate informa7 tion related to newborn, child, and maternal health. 

8 ‘‘(11) Activities to develop and conduct needs 

9 assessments, baseline studies, targeted evaluations, 

10 or other information-gathering efforts for the design, 

11 monitoring, and evaluation of newborn, child, and 

12 maternal health efforts. 

13 ‘‘(12) Activities to integrate and coordinate as14 sistance provided under this section with existing 

15 health programs for— 

16 ‘‘(A) the prevention of the transmission of 

17 HIV from mother-to-child and other HIV/AIDS 

18 counseling, care, and treatment activities; 

19 ‘‘(B) malaria; 

20 ‘‘(C) tuberculosis; and 

21 ‘‘(D) child spacing. 

22 ‘‘(c) GUIDELINES.—To the maximum extent prac23 ticable, programs, projects, and activities carried out using 

24 assistance provided under this section shall be— 

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1 ‘‘(1) carried out through private and voluntary 

2 organizations, including faith-based organizations, 

3 and relevant international and multilateral organiza4 tions, including the GAVI Alliance and UNICEF, 

5 that demonstrate effectiveness and commitment to 

6 improving the health of newborns, children, and 

7 mothers; 

8 ‘‘(2) carried out with input by host countries, 

9 including civil society and local communities, as well 

10 as other donors and multilateral organizations; 

11 ‘‘(3) carried out with input by beneficiaries and 

12 other directly affected populations, especially women 

13 and marginalized communities; and 

14 ‘‘(4) designed to build the capacity of host 

15 country governments and civil society organizations. 

16 ‘‘(d) ANNUAL REPORT.—Not later than January 31 

17 of each year, the President shall transmit to Congress a 

18 report on the implementation of this section for the prior 

19 fiscal year. 

20 ‘‘(e) DEFINITIONS.—In this section: 

21 ‘‘(1) AIDS.—The term ‘AIDS’ has the meaning 

22 given the term in section 104A(g)(1) of this Act. 

23 ‘‘(2) HIV.—The term ‘HIV’ has the meaning 

24 given the term in section 104A(g)(2) of this Act. 

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1 ‘‘(3) HIV/AIDS.—The term ‘HIV/AIDS’ has 

2 the meaning given the term in section 104A(g)(3) of 

3 this Act.’’. 

4 (b) CONFORMING AMENDMENTS.—The Foreign As5 sistance Act of 1961 (22 U.S.C. 2151 et seq.) is amend6 ed— 

7 (1) in section 104(c)(2) (as redesignated by 

8 subsection (a)(1)(B) of this section), by striking 

9 ‘‘and 104C’’ and inserting ‘‘104C, and 104D’’; 

10 (2) in section 104A— 

11 (A) in subsection (c)(1), by inserting ‘‘and 

12 section 104D’’ after ‘‘section 104(c)’’; and 

13 (B) in subsection (f), by striking ‘‘section 

14 104(c), this section, section 104B, and section 

15 104C’’ and inserting ‘‘section 104(c), this sec16 tion, section 104B, section 104C, and section 

17 104D’’; 

18 (3) in subsection (c) of section 104B, by insert19 ing ‘‘and section 104D’’ after ‘‘section 104(c)’’; 

20 (4) in subsection (c) of section 104C, by insert21 ing ‘‘and section 104D’’ after ‘‘section 104(c)’’; and 

22 (5) in the first sentence of section 119(c), by 

23 striking ‘‘section 104(c)(2), relating to Child Sur24 vival Fund’’ and inserting ‘‘section 104D’’. 

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1 SEC. 4. DEVELOPMENT OF STRATEGY TO REDUCE MOR2 TALITY AND IMPROVE THE HEALTH OF 

3 NEWBORNS, CHILDREN, AND MOTHERS IN 

4 DEVELOPING COUNTRIES. 

5 (a) DEVELOPMENT OF STRATEGY.—The President 

6 shall develop and implement a comprehensive strategy to 

7 improve the health of newborns, children, and mothers in 

8 developing countries. 

9 (b) COMPONENTS.—The comprehensive United 

10 States Government strategy developed pursuant to sub11 section (a) shall include the following: 

12 (1) An identification of not less than 60 coun13 tries with priority needs for the 5-year period begin14 ning on the date of the enactment of this Act based 

15 on— 

16 (A) the number and rate of neonatal 

17 deaths; 

18 (B) the number and rate of child deaths; 

19 and 

20 (C) the number and rate of maternal 

21 deaths. 

22 (2) For each country identified in paragraph 

23 (1)— 

24 (A) an assessment of the most common 

25 causes of newborn, child, and maternal mor26 tality; 

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1 (B) a description of the programmatic 

2 areas and interventions providing maximum 

3 health benefits to populations at risk and max4 imum reduction in mortality; 

5 (C) an assessment of the investments need6 ed in identified programs and interventions to 

7 achieve the greatest results; 

8 (D) a description of how United States as9 sistance complements and leverages efforts by 

10 other donors and builds capacity and self-suffi11 ciency among recipient countries; and 

12 (E) a description of goals and objectives 

13 for improving newborn, child, and maternal 

14 health, including, to the extent feasible, objec15 tive and quantifiable indicators. 

16 (3) An expansion of the Child Survival and 

17 Health Grants Program of the United States Agency 

18 for International Development, at least propor19 tionate to any increase in child and maternal health 

20 assistance, to provide additional support programs 

21 and interventions determined to be efficacious and 

22 cost-effective. 

23 (4) Enhanced coordination among relevant de24 partments and agencies of the United States Gov25 ernment engaged in activities to improve the health 

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1 and well-being of newborns, children, and mothers in 

2 developing countries. 

3 (5) A description of the measured or estimated 

4 impact on child morbidity and mortality of each 

5 project or program. 

6 (c) REPORT.—Not later than 180 days after the date 

7 of the enactment of this Act, the President shall transmit 

8 to Congress a report that contains the strategy described 

9 in this section. 

10 SEC. 5. INTERAGENCY TASK FORCE ON CHILD SURVIVAL 

11 AND MATERNAL HEALTH IN DEVELOPING 

12 COUNTRIES. 

13 (a) ESTABLISHMENT.—There is established a task 

14 force to be known as the Interagency Task Force on Child 

15 Survival and Maternal Health in Developing Countries (in 

16 this section referred to as the ‘‘Task Force’’). 

17 (b) DUTIES.— 

18 (1) IN GENERAL.—The Task Force shall assess, 

19 monitor, and evaluate the progress and contributions 

20 of relevant departments and agencies of the United 

21 States Government in achieving MDGs 4 and 5 in 

22 developing countries, including by— 

23 (A) identifying and evaluating programs 

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1 tribute to the reduction of child and maternal 

2 mortality rates; 

3 (B) assessing effectiveness of programs, 

4 interventions, and strategies toward achieving 

5 the maximum reduction of child and maternal 

6 mortality rates; 

7 (C) assessing the level of coordination 

8 among relevant departments and agencies of 

9 the United States Government, the inter10 national community, international organiza11 tions, faith-based organizations, academic insti12 tutions, and the private sector; 

13 (D) assessing the contributions made by 

14 United States-funded programs toward achiev15 ing MDGs 4 and 5; 

16 (E) identifying the bilateral efforts of other 

17 nations and multilateral efforts toward achiev18 ing MDGs 4 and 5; and 

19 (F) preparing the annual report required 

20 by subsection (f). 

21 (2) CONSULTATION.—To the maximum extent 

22 practicable, the Task Force shall consult with indi23 viduals with expertise in the matters to be consid24 ered by the Task Force who are not officers or em25 ployees of the United States Government, including 

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1 representatives of United States-based nongovern2 mental organizations (including faith-based organi3 zations and private foundations), academic institu4 tions, private corporations, the United Nations Chil5 dren’s Fund (UNICEF), and the World Bank. 

6 (c) MEMBERSHIP.— 

7 (1) NUMBER AND APPOINTMENT.—The Task 

8 Force shall be composed of the following members: 

9 (A) The Administrator of the United 

10 States Agency for International Development. 

11 (B) The Assistant Secretary of State for 

12 Population, Refugees and Migration. 

13 (C) The Coordinator of United States Gov14 ernment Activities to Combat HIV/AIDS Glob15 ally. 

16 (D) The Director of the Office of Global 

17 Health Affairs of the Department of Health 

18 and Human Services. 

19 (E) The Under Secretary for Food, Nutri20 tion and Consumer Services of the Department 

21 of Agriculture. 

22 (F) The Chief Executive Officer of the Mil23 lennium Challenge Corporation. 

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1 (G) Other officials of relevant departments 

2 and agencies of the Federal Government who 

3 shall be appointed by the President. 

4 (H) Two ex officio members appointed by 

5 the Speaker of the House of Representatives in 

6 consultation with the Minority Leader of the 

7 House of Representatives. 

8 (I) Two ex officio members appointed by 

9 the Majority Leader of the Senate in consulta10 tion with the Minority Leader of the Senate. 

11 (2) CHAIRPERSON.—The Administrator of the 

12 United States Agency for International Development 

13 shall serve as chairperson of the Task Force. 

14 (d) MEETINGS.—The Task Force shall meet on a reg15 ular basis, not less often than quarterly, on a schedule 

16 to be agreed upon by the members of the Task Force, and 

17 starting not later than 90 days after the date of the enact18 ment of this Act. 

19 (e) DEFINITION.—In this subsection, the term ‘‘Mil20 lennium Development Goals’’ means the key development 

21 objectives described in the United Nations Millennium 

22 Declaration, as contained in United Nations General As23 sembly Resolution 55/2 (September 2000). 

24 (f) REPORT.—Not later than 120 days after the date 

25 of the enactment of this Act, and not later than April 30 

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1 of each year thereafter, the Task Force shall submit to 

2 Congress and the President a report on the implementa3 tion of this section. 

4 SEC. 6. AUTHORIZATION OF APPROPRIATIONS. 

5 (a) IN GENERAL.—There are authorized to be appro6 priated to carry out this Act, and the amendments made 

7 by this Act, $600,000,000 for fiscal year 2008, 

8 $900,000,000 for fiscal year 2009, $1,200,000,000 for fis9 cal year 2010, and $1,600,000,000 for each of fiscal years 

10 2011 and 2012. 

11 (b) AVAILABILITY OF FUNDS.—Amounts appro12 priated pursuant to the authorization of appropriations 

13 under subsection (a) are authorized to remain available 

14 until expended. 

Æ 

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