II 

Calendar No. 633 

110TH CONGRESS 

2D SESSION S. 1418 

[Report No. 110–282] 

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, Mr. LEAHY, Ms. MIKULSKI, 

Ms. SNOWE, Mr. INOUYE, Mr. WHITEHOUSE, Mr. JOHNSON, Mr. KERRY, 

Mrs. MURRAY, Mr. DURBIN, Mrs. BOXER, Mr. SANDERS, Mr. MENENDEZ, Mr. LAUTENBERG, Mr. CASEY, Mr. CARDIN, Mr. LEVIN, Ms. CANTWELL, Mrs. LINCOLN, Ms. STABENOW, Mr. CORKER, and Mr. OBAMA) 

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

Committee on Foreign Relations 

APRIL 9, 2008 

Reported by Mr. BIDEN, with an amendment 

[Strike out all after the enacting clause and insert the part printed in italic] 

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, 

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1 SECTION 1. SHORT TITLE. 

2 This Act may be cited as the ‘‘United States Commit3 ment to Global Child Survival Act of 2007’’. 

4 SEC. 2. FINDINGS AND PURPOSES. 

5 (a) FINDINGS.—Congress makes the following find6 ings: 

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

8 countries in committing to achieve 8 Millennium De9 velopment Goals (MDGs) by 2015, including ‘‘MDG 

10 4’’ and ‘‘MDG 5’’ that aim to reduce the mortality 

rate of children under the age of 5 by 2 11 ⁄3 and maternal mortality rate by 3 12 ⁄4 in developing countries, re13 spectively. 

14 (2) The significant commitment of the United 

15 States to reducing child mortality in the developing 

16 world contributed to a 50-percent reduction in the 

17 mortality rate of children under the age of 5 be18 tween 1960 and 1990, and over the past 20 years, 

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

20 in child survival programs run by the United States 

21 Agency for International Development. 

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

23 medical journals, the Lancet, despite United States 

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

25 countries that account for 94 percent of under-5 

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

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

2 progress, although they need to accelerate the speed, 

3 and fourteen countries are cause for serious con4 cern’’. 

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

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

7 preventable and treatable causes, including 

8 4,000,000 newborns who die in the first 4 weeks of 

9 life. 

10 (5) 3,000,000 children die each year due to lack 

11 of access to low-cost antibiotics and antimalarial 

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

13 vaccines are readily available. 

14 (6) Maternal health is an important deter15 minant of neonatal survival with maternal death in16 creasing death rates for newborns to as high as 100 

17 percent in certain countries in the developing world. 

18 (7) Approximately 525,000 women die every 

19 year in the developing world from causes related to 

20 pregnancy and childbirth. 

21 (8) Risk factors for maternal death in devel22 oping countries include pregnancy and childbirth at 

23 an early age, closely spaced births, infectious dis24 eases, malnutrition, and complications during child25 birth. 

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(9) According to the Lancet, nearly 2 1 ⁄3 of an2 nual child and newborn deaths, 6,000,000 children, 

3 can be avoided in accordance with MDG 4 if a pack4 age of high impact, low-cost interventions were made 

5 available at a total, additional, annual cost of 

6 $5,100,000,000, including oral rehydration therapy 

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

8 treat respiratory infections ($0.25 per treatment). 

9 (10) 2,000,000 lives could be saved annually by 

10 providing oral rehydration therapy prepared with 

11 clean water. 

12 (11) Exclusive breastfeeding—giving only 

13 breast milk for the first 6 months of life—could pre14 vent an estimated 1,300,000 newborn and infant 

15 deaths each year, primarily by protecting against di16 arrhea and pneumonia. 

17 (12) Expansion of clinical care for newborns 

18 and mothers, such as clean delivery by skilled at19 tendants, emergency obstetric care, and neonatal re20 suscitation, can avert 50 percent of newborn deaths 

21 and reduce maternal mortality. 

22 (13) The United Nations Children’s Fund 

23 (UNICEF), with support from the World Health Or24 ganization, the World Bank, and the African Union, 

25 has successfully demonstrated the accelerated child 

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1 survival and development program in Senegal, Mali, 

2 Benin, and Ghana, reducing mortality of children 

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

4 using low-cost, high-impact interventions. 

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

6 W. Bush stated before the United Nations High7 Level Plenary Meeting that the United States is 

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

9 (15) Nearing the halfway point of attaining the 

10 MDGs by 2015 with thousands of avoidable new11 born, child, and maternal deaths still occurring, the 

12 United States must immediately scale up its funding 

13 and delivery of proven low-cost, life-saving interven14 tions in order to fulfill its commitment to help en15 sure that MDGs 4 and 5 are met. 

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

17 (1) to develop a strategy to reduce mortality 

18 and improve the health of newborns, children, and 

19 mothers, and authorize assistance for its implemen20 tation; and 

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

22 and evaluate the progress and contributions of rel23 evant departments and agencies of the United States 

24 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. 

15 SECTION 1. SHORT TITLE. 

16 This Act may be cited as the ‘‘United States Commit17 ment to Global Child Survival Act of 2007’’. 

18 SEC. 2. FINDINGS AND PURPOSES. 

19 (a) FINDINGS.—Congress makes the following findings: 

20 (1) In 2000, the United States joined 188 coun21 tries in committing to achieve 8 Millennium Develop22 ment Goals (MDGs) by 2015, including ‘‘MDG 4 (Re23 duce child mortality)’’ and ‘‘MDG 5 (Improve mater24 nal health)’’ that aim to reduce the mortality rate of 

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children under the age of 5 by 2 1 ⁄3 and maternal mortality rate by 3 2 ⁄4 in developing countries, respectively. 

3 (2) The significant commitment of the United 

4 States to reducing child mortality in the developing 

5 world contributed to a 22-percent reduction in the 

6 mortality rate of children under the age of 5 between 

7 1990 and 2006, and over the past 20 years, the 

8 United States has invested over $6,000,000,000 in 

9 child survival programs run by the United States 

10 Agency for International Development. 

11 (3) According to one of the world’s leading med12 ical journals, the Lancet, despite United States and 

13 global efforts to achieve MDG 4, of the 60 countries 

14 that account for 94 percent of under-5 child deaths, 

15 ‘‘only seven countries are on track to meet MDG 4, 

16 thirty-nine countries are making some progress, al17 though they need to accelerate the speed, and fourteen 

18 countries are cause for serious concern’’. 

19 (4) 10,500,000 children under the age of 5 die 

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

21 preventable and treatable causes, including 4,000,000 

22 newborns who die in the first 4 weeks of life. 

23 (5) 3,000,000 children die each year due to lack 

24 of access to low-cost antibiotics and antimalarial 

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1 drugs, and 1,700,000 die from diseases for which vac2 cines are readily available. 

3 (6) Maternal health is an important determinant 

4 of neonatal survival with maternal death increasing 

5 death rates for newborns by 100 percent in certain 

6 countries in the developing world. 

7 (7) Approximately 525,000 women die every 

8 year in the developing world from causes related to 

9 pregnancy and childbirth. 

10 (8) Risk factors for maternal death in developing 

11 countries include pregnancy and childbirth at an 

12 early age, closely spaced births, infectious diseases, 

13 malnutrition, and complications during childbirth. 

(9) According to the Lancet, nearly 2 14 ⁄3 of annual 

15 child and newborn deaths, 6,000,000 children, can be 

16 avoided in accordance with MDG 4 if a package of 

17 high impact, low-cost interventions were made avail18 able at a total, additional, annual cost of 

19 $5,100,000,000, including oral rehydration therapy 

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

21 treat respiratory infections ($0.25 per treatment). 

22 (10) 2,000,000 lives could be saved annually by 

23 providing oral rehydration therapy prepared with 

24 clean water. 

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1 (11) Exclusive breast feeding—giving only breast 

2 milk for the first 6 months of life—could prevent an 

3 estimated 1,300,000 newborn and infant deaths each 

4 year, primarily by protecting against diarrhea and 

5 pneumonia. 

6 (12) Expansion of clinical care for newborns and 

7 mothers, such as clean delivery by skilled attendants, 

8 emergency obstetric care, and neonatal resuscitation, 

9 can avert 50 percent of newborn deaths and reduce 

10 maternal mortality. 

11 (13) The United Nations Children’s Fund 

12 (UNICEF), with support from the World Health Or13 ganization, the World Bank, and the African Union, 

14 has successfully demonstrated the accelerated child 

15 survival and development program in Senegal, Mali, 

16 Benin, and Ghana, reducing mortality of children 

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

18 using low-cost, high-impact interventions. 

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

20 W. Bush stated before the United Nations High-Level 

21 Plenary Meeting that the United States is ‘‘committed 

22 to the Millennium Development Goals’’. 

23 (15) Nearing the halfway point of attaining the 

24 MDGs by 2015 with thousands of avoidable newborn, 

25 child, and maternal deaths still occurring, the United 

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1 States will need to immediately scale up its funding 

2 and delivery of proven low-cost, life-saving interven3 tions in order to fulfill its commitment to help ensure 

4 that MDGs 4 and 5 are met. 

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

6 (1) to develop a strategy to reduce mortality and 

7 improve the health of newborns, children, and moth8 ers, and authorize assistance for its implementation; 

9 and 

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

11 and evaluate the progress and contributions of rel12 evant departments and agencies of the United States 

13 Government in achieving MDGs 4 and 5. 

14 SEC. 3. ASSISTANCE TO IMPROVE THE HEALTH OF 

15 NEWBORNS, CHILDREN, AND MOTHERS IN DE16 VELOPING COUNTRIES. 

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

18 Assistance Act of 1961 (22 U.S.C. 2151 et seq.) is amend19 ed— 

20 (1) in section 104(c)— 

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

22 (B) by redesignating paragraph (4) as 

23 paragraph (2); and 

24 (2) by inserting after section 104C the following 

25 new section: 

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1 ‘‘SEC. 104D. ASSISTANCE TO REDUCE MORTALITY AND IM2 PROVE THE HEALTH OF NEWBORNS, CHIL3 DREN, AND MOTHERS. 

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

5 104(c), the President is authorized to furnish assistance, on 

6 such terms and conditions as the President may determine, 

7 to reduce mortality and improve the health of newborns, 

8 children, and mothers in developing countries. 

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

10 under subsection (a) shall, to the maximum extent prac11 ticable, include— 

12 ‘‘(1) activities to improve newborn care and 

13 treatment; 

14 ‘‘(2) activities to treat childhood illness, includ15 ing increasing access to appropriate treatment for di16 arrhea, pneumonia, and other life-threatening child17 hood illnesses; 

18 ‘‘(3) activities to improve child and maternal 

19 nutrition, including the delivery of iron, zinc, vita20 min A, iodine, and other key micronutrients and the 

21 promotion of breast feeding; 

22 ‘‘(4) activities to strengthen the delivery of im23 munization services, including efforts to eliminate 

24 polio; 

25 ‘‘(5) activities to improve birth preparedness and 

26 maternity services; 

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1 ‘‘(6) activities to improve the recognition and 

2 treatment of obstetric complications and disabilities; 

3 ‘‘(7) activities to improve household-level behav4 ior related to safe water, hygiene, exposure to indoor 

5 smoke, and environmental toxins such as lead; 

6 ‘‘(8) activities to improve capacity for health 

7 governance, health finance, and the health workforce, 

8 including support for training clinicians, nurses, 

9 technicians, sanitation and public health workers, 

10 community-based health workers, midwives, birth at11 tendants, peer educators, volunteers, and private sec12 tor enterprises; 

13 ‘‘(9) activities to address antimicrobial resist14 ance in child and maternal health; 

15 ‘‘(10) activities to establish and support the 

16 management information systems of host country in17 stitutions and the development and use of tools and 

18 models to collect, analyze, and disseminate informa19 tion related to newborn, child, and maternal health; 

20 ‘‘(11) activities to develop and conduct needs as21 sessments, baseline studies, targeted evaluations, or 

22 other information-gathering efforts for the design, 

23 monitoring, and evaluation of newborn, child, and 

24 maternal health efforts; and 

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1 ‘‘(12) activities to integrate and coordinate as2 sistance provided under this section with existing 

3 health programs for— 

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

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

6 counseling, care, and treatment activities; 

7 ‘‘(B) malaria; 

8 ‘‘(C) tuberculosis; and 

9 ‘‘(D) child spacing. 

10 ‘‘(c) GUIDELINES.—To the maximum extent prac11 ticable, programs, projects, and activities carried out using 

12 assistance provided under this section shall be— 

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

14 organizations, including faith-based organizations, 

15 and relevant international and multilateral organiza16 tions, including the GAVI Alliance and UNICEF, 

17 that demonstrate effectiveness and commitment to im18 proving the health of newborns, children, and moth19 ers; 

20 ‘‘(2) carried out with input by host countries, in21 cluding civil society and local communities, as well as 

22 other donors and multilateral organizations; 

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

24 other directly affected populations, especially women 

25 and marginalized communities; and 

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1 ‘‘(4) designed to build the capacity of host coun2 try governments and civil society organizations. 

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

4 2009, and annually thereafter for 4 years, the President 

5 shall transmit to Congress a report on the implementation 

6 of this section for the prior fiscal year. The report shall 

7 include the most recent report submitted to the President 

8 by the Interagency Task Force on Child Survival and Ma9 ternal Health in Developing Countries under section 5(f) 

10 of the United States Commitment to Global Child Survival 

11 Act of 2007. 

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

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

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

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

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

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

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

19 Act.’’. 

20 (b) CONFORMING AMENDMENTS.—The Foreign Assist21 ance Act of 1961 (22 U.S.C. 2151 et seq.) is amended— 

22 (1) in section 104(c)(2) (as redesignated by sub23 section (a)(1)(B) of this section), by striking ‘‘and 

24 104C’’ and inserting ‘‘104C, and 104D’’; 

25 (2) in section 104A— 

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

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

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

4 104(c), this section, section 104B, and section 

5 104C’’ and inserting ‘‘section 104(c), this section, 

6 section 104B, section 104C, and section 104D’’; 

7 (3) in subsection (c) of section 104B, by insert8 ing ‘‘and section 104D’’ after ‘‘section 104(c)’’; 

9 (4) in subsection (c) of section 104C, by inserting 

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

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

12 striking ‘‘section 104(c)(2), relating to Child Survival 

13 Fund’’ and inserting ‘‘section 104D’’. 

14 SEC. 4. DEVELOPMENT OF STRATEGY TO REDUCE MOR15 TALITY AND IMPROVE THE HEALTH OF 

16 NEWBORNS, CHILDREN, AND MOTHERS IN DE17 VELOPING COUNTRIES. 

18 (a) DEVELOPMENT OF STRATEGY.—The President 

19 shall develop and implement a comprehensive strategy to 

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

21 developing countries. 

22 (b) COMPONENTS.—The comprehensive United States 

23 Government strategy developed pursuant to subsection (a) 

24 shall include the following: 

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1 (1) Using data compiled by the United Nations, 

2 the World Bank, and other international organiza3 tions, an identification of not less than 60 countries 

4 with priority needs for the 5-year period beginning 

5 on the date of the enactment of this Act, to include— 

6 (A) the number and rate of neonatal deaths; 

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

8 and 

9 (C) the number and rate of maternal 

10 deaths. 

11 (2) For each country identified in paragraph 

12 (1)— 

13 (A) an assessment of the most common 

14 causes of newborn, child, and maternal mor15 tality; 

16 (B) a description of the programmatic areas 

17 and interventions providing maximum health 

18 benefits to populations at risk and maximum re19 duction in mortality; 

20 (C) an assessment of the investments needed 

21 in identified programs and interventions to 

22 achieve the greatest results; 

23 (D) a description of how United States as24 sistance complements and leverages efforts by 

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1 other donors and builds capacity and self-suffi2 ciency among recipient countries; and 

3 (E) a description of goals and objectives for 

4 improving newborn, child, and maternal health, 

5 including, to the extent feasible, objective and 

6 quantifiable indicators. 

7 (3) An expansion of the Child Survival and 

8 Health Grants Program of the United States Agency 

9 for International Development, at least proportionate 

10 to any increase in child and maternal health assist11 ance, to provide additional support programs and 

12 interventions determined to be efficacious and cost-ef13 fective. 

14 (4) Enhanced coordination among relevant de15 partments and agencies of the United States Govern16 ment engaged in activities to improve the health and 

17 well-being of newborns, children, and mothers in de18 veloping countries. 

19 (5) A description of the measured or estimated 

20 impact on child morbidity and mortality of each 

21 project or program. 

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

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

24 to Congress a report that contains the strategy described 

25 in this section. 

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1 SEC. 5. INTERAGENCY TASK FORCE ON CHILD SURVIVAL 

2 AND MATERNAL HEALTH IN DEVELOPING 

3 COUNTRIES. 

4 (a) ESTABLISHMENT.—There is established a task force 

5 to be known as the Interagency Task Force on Child Sur6 vival and Maternal Health in Developing Countries (in this 

7 section referred to as the ‘‘Task Force’’). 

8 (b) DUTIES.— 

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

10 monitor, and evaluate the progress and contributions 

11 of relevant departments and agencies of the United 

12 States Government in achieving MDGs 4 and 5 in de13 veloping countries, including by— 

14 (A) identifying and evaluating programs 

15 and interventions that directly or indirectly con16 tribute to the reduction of child and maternal 

17 mortality rates; 

18 (B) assessing effectiveness of programs, 

19 interventions, and strategies toward achieving 

20 the maximum reduction of child and maternal 

21 mortality rates; 

22 (C) assessing the level of coordination 

23 among relevant departments and agencies of the 

24 United States Government, the international 

25 community, international organizations, faith26 based organizations, academic institutions, the 

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1 private sector, and host country for input and 

2 coordination; 

3 (D) assessing the contributions made by 

4 United States-funded programs toward achieving 

5 MDGs 4 and 5; 

6 (E) identifying the bilateral efforts of other 

7 nations and multilateral efforts toward achieving 

8 MDGs 4 and 5; and 

9 (F) preparing the annual report required 

10 by subsection (f). 

11 (2) CONSULTATION.—To the maximum extent 

12 practicable, the Task Force shall consult with individ13 uals with expertise in the matters to be considered by 

14 the Task Force who are not officers or employees of 

15 the United States Government, including representa16 tives of United States-based nongovernmental organi17 zations (including faith-based organizations and pri18 vate foundations), academic institutions, private cor19 porations, the United Nations Children’s Fund 

20 (UNICEF), and the World Bank. 

21 (c) MEMBERSHIP.— 

22 (1) NUMBER AND APPOINTMENT.—The Task 

23 Force shall be composed of the following members: 

24 (A) The Administrator of the United States 

25 Agency for International Development. 

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1 (B) The Assistant Secretary of State for 

2 Population, Refugees and Migration. 

3 (C) The Coordinator of United States Gov4 ernment Activities to Combat HIV/AIDS Glob5 ally. 

6 (D) The Director of the Office of Global 

7 Health Affairs of the Department of Health and 

8 Human Services. 

9 (E) The Under Secretary for Food, Nutri10 tion and Consumer Services of the Department 

11 of Agriculture. 

12 (F) The Chief Executive Officer of the Mil13 lennium Challenge Corporation. 

14 (G) Other officials of relevant departments 

15 and agencies of the Federal Government who 

16 shall be appointed by the President. 

17 (H) Two ex officio members appointed by 

18 the Speaker of the House of Representatives in 

19 consultation with the minority leader of the 

20 House of Representatives. 

21 (I) Two ex officio members appointed by the 

22 majority leader of the Senate in consultation 

23 with the minority leader of the Senate. 

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1 (2) CHAIRPERSON.—The Administrator of the 

2 United States Agency for International Development 

3 shall serve as chairperson of the Task Force. 

4 (d) MEETINGS.—Members of the Task Force or their 

5 designees shall meet on a regular basis, not less often than 

6 quarterly, on a schedule to be agreed upon by the members 

7 of the Task Force, and starting not later than 90 days after 

8 the date of the enactment of this Act. 

9 (e) DEFINITION.—In this subsection, the term ‘‘Millen10 nium Development Goals’’ means the key development objec11 tives described in the United Nations Millennium Declara12 tion, as contained in United Nations General Assembly 

13 Resolution 55/2 (September 2000). 

14 (f) REPORT.—Not later than 180 days after the date 

15 of the enactment of this Act and annually thereafter for 4 

16 years, the Task Force shall submit to the President a report 

17 on the implementation of this section. 

18 SEC. 6. AUTHORIZATION OF APPROPRIATIONS. 

19 (a) IN GENERAL.—There are authorized to be appro20 priated to carry out this Act, and the amendments made 

21 by this Act— 

22 (1) up to $600,000,000 for fiscal year 2008; 

23 (2) up to $900,000,000 for fiscal year 2009; 

24 (3) up to $1,200,000,000 for fiscal year 2010; 

25 and 

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1 (4) up to $1,600,000,000 for each of fiscal years 

2 2011 and 2012. 

3 (b) AVAILABILITY OF FUNDS.—Amounts appropriated 

4 pursuant to the authorization of appropriations under sub5 section (a) are authorized to remain available until ex6 pended. 

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Calendar No. 633 

110TH CONGRESS 

2D SESSION S. 1418 

[Report No. 110

–282] 

A BILL 

To provide assistance to improve the health of 

countries, and for other purposes. newborns, children, and mothers in developing 

APRIL 9, 2008 

Reported with an amendment 

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