I 

110TH CONGRESS 

1ST SESSION H. R. 1225 

To amend the Foreign Assistance Act of 1961 to improve voluntary family 

planning programs in developing countries, and for other purposes. 

IN THE HOUSE OF REPRESENTATIVES 

FEBRUARY 28, 2007 

Ms. MCCOLLUM of Minnesota (for herself, Mr. RAMSTAD, Mr. PAYNE, Mr. 

SHAYS, and Mr. OBERSTAR) introduced the following bill; which was referred to the Committee on Foreign Affairs 

A BILL 

To amend the Foreign Assistance Act of 1961 to improve 

voluntary family planning programs 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 ‘‘Focus on Family 

5 Health Worldwide Act of 2007’’. 

6 SEC. 2. FINDINGS. 

7 Congress finds the following: 

8 (1) Since 1965, the people and Government of 

9 the United States have supported international volVerDate Aug 31 2005 22:03 Mar 01, 2007 Jkt 059200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6201 E:\BILLS\H1225.IH H1225

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1 untary family planning programs, increasing the use 

2 of modern contraceptives in the developing world 

3 from fewer than 10 percent of couples in 1965 to 

4 more than 40 percent of couples today. 

5 (2) United States funding for international 

6 family planning is today providing services to 20 

7 million couples in the world’s poorest countries, con8 tributing to family well-being by improving maternal 

9 health, reducing maternal and infant deaths, pre10 venting abortions, and improving the lives of millions 

11 of families. 

12 (3) The United States spends on average three 

13 cents per American per week for international family 

14 planning programs. 

15 (4) In the developing world, the use of modern 

16 contraceptives reduces unintended pregnancies and 

17 the probability that a woman will have an abortion 

18 by 85 percent. 

19 (5) President George W. Bush has stated that 

20 one of the best ways to prevent abortion is by pro21 viding quality voluntary family planning programs. 

22 (6) In developing countries at least 120 million 

23 married couples who would like to postpone their 

24 next pregnancy, or have no more children, do not 


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1 have access to or are not using modern contracep2 tion. 

3 (7) In sub-Saharan Africa, 46 percent of 

4 women who desire to delay or end childbearing re5 main without access to voluntary family planning 

6 and at risk of unintended pregnancy. 

7 (8) Each year more than 525,000 women die 

8 from causes related to pregnancy and childbirth with 

9 99 percent of these deaths occurring in developing 

10 countries. An additional eight million women each 

11 year suffer serious health complications from preg12 nancy and childbirth. 

13 (9) A lack of birth spacing resulting in birth in14 tervals of 9 to 14 months increases the risk of ma15 ternal death by 250 percent. 

16 (10) Birth spacing of at least 36 months is as17 sociated with the lowest mortality risk for infants 

18 and children under five years of age. 

19 (11) Approximately 10.8 million children under 

20 the age of five die each year, more than 30,000 

21 every day, frequently from low birth-weight or from 

22 causes related to complications in the mother’s preg23 nancy. 

24 (12) Providing access to modern contraception 

25 in less developed countries could prevent 1.4 million 


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1 infant deaths and 142,000 maternal deaths annu2 ally. 

3 (13) Linking family planning programs with 

4 HIV/AIDS prevention, care, and treatment pro5 grams helps to meet the multiple health needs of 

6 couples while effectively using scarce financial and 

7 human resources. 

8 (14) For HIV-positive women, family planning 

9 is the most efficacious and cost-effective intervention 

10 to prevent unintended pregnancies, decrease the risk 

11 of maternal death, and avoid the transmission of 

12 HIV from mother-to-child, premature birth, low 

13 birth weight, or infant death. 

14 (15) Rapid population growth over-stresses vital 

15 resources, such as water, agricultural land, forests, 

16 and wildlife, contributing to extreme poverty, infec17 tious disease, limited access to education, environ18 mental destruction, food insecurity, and resultant 

19 malnutrition. 

20 (16) Malnutrition in children is a contributing 

21 factor to more than one-half of all child mortality, 

22 and malnutrition in mothers account for a substan23 tial proportion of neonatal mortality. 

24 (17) United States-funded family planning pro25 grams have been successfully linked with the conVerDate Aug 31 2005 22:03 Mar 01, 2007 Jkt 059200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\H1225.IH H1225

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1 servation of natural resources to ease growing popu2 lation pressures, improve food security, and keep 

3 families healthy and communities economically via4 ble. 

5 (18) Between 2005 and 2050, if family plan6 ning needs remain unmet, the population is expected 

7 to grow by more than 300 percent in the developing 

8 countries of Afghanistan, Burkina Faso, Burundi, 

9 Chad, the Democratic Republic of the Congo, the 

10 Republic of the Congo, Guinea-Bissau, Liberia, Mali, 

11 Niger, the Democratic Republic of Timor-Leste, and 

12 Uganda. 

13 SEC. 3. SENSE OF CONGRESS. 

14 It is the sense of Congress that it should be a United 

15 States policy objective to— 

16 (1) partner with developing countries to expand 

17 access to voluntary family planning programs and 

18 the supply of modern contraceptives in order to— 

19 (A) meet growing demand to allow couples 

20 to achieve their desired family size; 

21 (B) reduce maternal and child mortality; 

22 (C) reduce unintended pregnancies and re23 sulting abortions; 

24 (D) reduce the incidence of HIV trans25 mission from mother-to-child and extend the 


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1 lives of HIV-positive women thus reducing the 

2 number of orphaned children; 

3 (E) conserve vital natural resources, in4 cluding water, agricultural land, and forested 

5 lands; 

6 (F) improve food security; and 

7 (G) enhance opportunities for lasting social 

8 and economic development; and 

9 (2) strengthen public heath initiatives world10 wide by provide training, research, and services for 

11 a wide variety of modern contraceptives and family 

12 planning methods that are designed and imple13 mented based on— 

14 (A) community participation; 

15 (B) the needs and values of beneficiaries; 

16 and 

17 (C) adherence to the principles of vol18 untary participation and informed consent. 

19 SEC. 4. ASSISTANCE TO IMPROVE VOLUNTARY FAMILY 

20 PLANNING PROGRAMS IN DEVELOPING 

21 COUNTRIES. 

22 (a) AMENDMENTS.—Section 104(b) of the Foreign 

23 Assistance Act of 1961 (22 U.S.C. 2151b(b)) is amend24 ed— 


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1 (1) in the first sentence, by striking ‘‘In order 

2 to’’ and inserting the following: 

3 ‘‘(1) IN GENERAL.—In order to’’; and 

4 (2) by adding at the end the following new 

5 paragraph: 

6 ‘‘(2) ASSISTANCE TO IMPROVE VOLUNTARY

7 FAMILY PLANNING PROGRAMS.— 

8 ‘‘(A) IN GENERAL.—The President, acting 

9 through the Administrator of the United States 

10 Agency for International Development, is au11 thorized to provide assistance, on such terms 

12 and conditions as the President may determine, 

13 to improve voluntary family planning programs 

14 in developing countries. 

15 ‘‘(B) ACTIVITIES SUPPORTED.—Assistance 

16 provided under subparagraph (A) shall, to the 

17 maximum extent practicable, be used to— 

18 ‘‘(i) improve public knowledge of vol19 untary family planning programs, includ20 ing the availability of modern contracep21 tives and the health, economic, and natural 

22 resource benefits of voluntary family plan23 ning for individuals, families, and commu24 nities; 


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1 ‘‘(ii) support a wide range of public 

2 and private voluntary family planning pro3 grams, including networks for community4 based and subsidized commercial distribu5 tion of modern contraceptives; 

6 ‘‘(iii) expand formal and informal 

7 training for health care providers, health 

8 educators, including peer educators and 

9 outreach workers, managers, traditional 

10 birth attendants, counselors, and commu11 nity-based distribution agents; 

12 ‘‘(iv) provide improved coordination 

13 between voluntary family planning pro14 grams and programs that receive United 

15 States Government assistance for the pre16 vention of HIV/AIDS and other sexually 

17 transmitted infections, the prevention of 

18 mother-to-child HIV transmission, and the 

19 testing, treatment, and care of persons in20 fected with HIV/AIDS and affected by 

21 HIV/AIDS to strengthen activities under 

22 such programs and enhance the cost-effec23 tiveness of such programs; and 

24 ‘‘(v) strengthen supply chain logistics 

25 for the procurement and reliable distribuVerDate Aug 31 2005 22:03 Mar 01, 2007 Jkt 059200 PO 00000 Frm 00008 Fmt 6652 Sfmt 6201 E:\BILLS\H1225.IH H1225

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1 tion of safe and effective modern contra2 ceptives, including coordination with the 

3 supply chain for HIV/AIDS prevention, 

4 care, and treatment, to allow for maximum 

5 efficiency and cost-savings. 

6 ‘‘(C) PRIORITY.—In providing assistance 

7 under this paragraph, priority shall be given to 

8 developing countries with acute family planning 

9 and maternal health needs based on criteria 

10 such as— 

11 ‘‘(i) the level of unmet need for vol12 untary family planning and modern contra13 ceptives; 

14 ‘‘(ii) fertility rates; 

15 ‘‘(iii) high-risk birth rates; 

16 ‘‘(iv) the number of births unattended 

17 by skilled attendants; 

18 ‘‘(v) maternal mortality rates; 

19 ‘‘(vi) rates of mortality for infants 

20 and children under the age of five; 

21 ‘‘(vii) abortion rates; 

22 ‘‘(viii) the level of HIV/AIDS in 

23 women of reproductive age; and 

24 ‘‘(ix) additional criteria or country 

25 conditions, such as conflict, humanitarian 


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1 crisis, large populations of refugees or in2 ternally displaced persons, or areas in 

3 which population growth threatens food se4 curity, vital natural resources, biodiversity, 

5 or endangered species. 

6 ‘‘(D) DEFINITIONS.—In this paragraph: 

7 ‘‘(i) AIDS.—The term ‘AIDS’ has the 

8 meaning given the term in section 

9 104A(g)(1) of this Act. 

10 ‘‘(ii) HIV.—The term ‘HIV’ has the 

11 meaning given the term in section 

12 104A(g)(2) of this Act. 

13 ‘‘(iii) HIV/AIDS.—The term ‘HIV/ 

14 AIDS’ has the meaning given the term in 

15 section 104A(g)(3) of this Act.’’. 

16 (b) EFFECTIVE DATE.—The authority to provide as17 sistance under section 104(b)(2) of the Foreign Assistance 

18 Act of 1961, as added by subsection (a), applies with re19 spect to fiscal year 2008 and subsequent fiscal years. 

20 SEC. 5. REPORT. 

21 (a) REPORT.—Not later than one year after the date 

22 of the enactment of this Act, and biennially thereafter, the 

23 President, acting through the Administrator of the United 

24 States Agency for International Development, shall trans25 mit to the Committee on Foreign Affairs of the House 


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1 of Representatives and the Committee on Foreign Rela2 tions of the Senate a report on the implementation of sec3 tion 104(b)(2) of the Foreign Assistance Act of 1961 (as 

4 added by section 4(a)). 

5 (b) CONTENTS.—The report shall include— 

6 (1) a description of efforts to implement the 

7 policies set forth in section 104(b)(2) of the Foreign 

8 Assistance Act of 1961; 

9 (2) a description of the programs established 

10 pursuant to such section; and 

11 (3) a detailed assessment of the impact of pro12 grams established pursuant to such section, includ13 ing— 

14 (A) an estimate of annual expenditures on 

15 modern contraceptive commodities and activities 

16 in support of voluntary family planning pro17 grams on a country-by-country basis, to be 

18 based on information supplied by national gov19 ernments, donor agencies, and private sector 

20 entities, to the maximum extent practicable; 

21 (B) an assessment by country of the cur22 rent unmet need for, availability, and use of 

23 modern contraception; 

24 (C) an assessment of prior year and pro25 posed allocations of modern contraceptives in 


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1 voluntary family planning assistance by coun2 try, which describes how each country’s alloca3 tion meets the country’s needs; and 

4 (D) a description of the quality of funded 

5 voluntary family planning programs, as meas6 ured by survey data or best available estimates, 

7 including— 

8 (i) types of modern contraceptive 

9 methods offered to significant subgroups 

10 (defined by age, gender, income, and 

11 health profile, among others) on a reliable 

12 basis; 

13 (ii) information provided to bene14 ficiaries to enable decision making regard15 ing benefits, risks, and efficacy of modern 

16 contraceptives; 

17 (iii) mechanisms to encourage sustain18 ability of voluntary family planning pro19 grams; and 

20 (iv) voluntary family planning pro21 grams that are effective in responding to 

22 individual health needs of beneficiaries. 


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1 SEC. 6. AUTHORIZATION OF APPROPRIATIONS. 

2 There are authorized to be appropriated to the Presi3 dent to carry out section 104(b)(2) of the Foreign Assist4 ance Act of 1961, as added by section 4(a) of this Act— 

5 (1) $600,000,000 for fiscal year 2008; 

6 (2) $700,000,000 for fiscal year 2009; 

7 (3) $800,000,000 for fiscal year 2010; 

8 (4) $900,000,000 for fiscal year 2011; and 

9 (5) $1,000,000,000 for fiscal year 2012. 

Æ 


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