I

103D CONGRESS

1ST SESSION H. R. 2447

To amend the Foreign Assistance Act of 1961 to establish and strengthen

policies and programs for the early stabilization of world population

through the global expansion of reproductive choice, and for other purposes.

IN THE HOUSE OF REPRESENTATIVES

JUNE 17, 1993

Mr. BEILENSON (for himself and Mrs. MORELLA) introduced the following

bill; which was referred to the Committee on Foreign Affairs

A BILL

To amend the Foreign Assistance Act of 1961 to establish

and strengthen policies and programs for the early stabilization of world population through the global expansion of reproductive choice, 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 ‘‘International Popu5 lation Stabilization and Reproductive Health Act’’.
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1 SEC. 2. AUTHORITIES RELATING TO UNITED STATES POPU2 LATION ASSISTANCE.

3 Part I of the Foreign Assistance Act of 1961 is

4 amended—

5 (1) in section 104(b), by striking ‘‘on such

6 terms and conditions as he may determine’’ and in7 serting ‘‘in accordance with the provisions of chapter

8 12’’; and

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

10 chapter:

11 ‘‘CHAPTER 12—UNITED STATES

12 POPULATION ASSISTANCE

13 ‘‘SEC. 499. DEFINITION.

14 ‘‘For purposes of this chapter, the term ‘United

15 States population assistance’ means assistance provided

16 under section 104(b) of this Act.

17 ‘‘SEC. 499A. CONGRESSIONAL FINDINGS.

18 ‘‘The Congress makes the following findings:

19 ‘‘(1) Throughout much of the world, the lack of

20 access of women, particularly poor women, to basic

21 reproductive health services and information under22 mines women’s struggle for self-determination, con23 tributes to death and suffering among women and

24 their children, puts pressure on the land, forests,

25 and other natural resources on which many poor

26 families depend for their survival, and in other ways
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1 vitiates the efforts of families to lift themselves out

2 of the poverty in which over 1,000,000,000 of the

3 world’s more than 5,000,000,000 people live.

4 ‘‘(2) During the 1980s, nearly 800,000,000

5 people, a number three times greater than the popu6 lation of the United States, were added to the

7 world’s population.

8 ‘‘(3) Birthrates in many developing countries

9 are declining too slowly to prevent a near tripling of

10 the world’s population before stabilization can occur,

11 and although birthrates in some countries have de12 clined faster in recent years than anticipated, world

13 progress toward stabilization was noticeably slower

14 in the 1980s than in the 1970s.

15 ‘‘(4) After more than a quarter century of expe16 rience and research, the actions needed to bring

17 about a rapid decline in birthrates are well docu18 mented. The ability to exercise reproductive choice

19 must be expanded, and such expansion should occur

20 through broader dissemination and choice of contra21 ceptive services that involve the community and are

22 sufficient to meet the needs and values of those who

23 use them.

24 ‘‘(5) Although a number of religious and cul25 tural barriers to family planning remain, attitudes
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1 toward modern contraception have changed over the

2 last decade, and in many countries a large and

3 growing unmet desire exists for deferring or prevent4 ing pregnancy among women and men who are too

5 poor to pay the full cost of services.

6 ‘‘(6) Although many social and economic factors

7 affect desired family size, organized, accessible, and

8 affordable family planning programs have the most

9 rapid and strongest effect on birthrate because they

10 enable women and their families to determine the

11 timing and number of their children. Widespread

12 voluntary adoption of modern family planning meth13 ods and their successful long-term use depend on the

14 quality of reproductive health care services offered

15 and their responsiveness to individual and commu16 nity needs and values.

17 ‘‘(7) Millions of women, most of them mothers,

18 are killed or injured each year as a result of unsafe

19 abortions. The availability of safe and effective fam20 ily planning methods and services can help prevent

21 many of these tragedies.

22 ‘‘(8) The impact of human population growth,

23 combined with widespread poverty and unsustainable

24 patterns of natural resource consumption, is evident

25 in mounting signs of stress on the world’s environ-
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1 ment, particularly in tropical deforestation, erosion

2 of arable land and watersheds, extinction of plant

3 and animal species, global climate change, waste

4 management, and air and water pollution.

5 ‘‘(9) Traditionally, United States population as6 sistance has not focused on achieving specific goals

7 with respect to international population stabilization

8 or the expansion of reproductive choice. The absence

9 of clear goals in those areas has led to a lack of cri10 teria for allocating funds and evaluating program

11 success.

12 ‘‘SEC. 499B. DECLARATION OF POLICY.

13 ‘‘(a) IN GENERAL.—The Congress declares that to

14 reduce population growth and stabilize world population

15 at the lowest level feasible and thereby protect the global

16 environment, to provide greater self-determination for

17 women, and to improve the health and well-being of the

18 world’s families, a principal objective of the foreign policy

19 of the United States shall be to assist the international

20 community to—

21 ‘‘(1) achieve universal availability of high qual22 ity family planning services through a wide choice of

23 safe and effective means of contraception, including

24 programs of public education and other health and
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1 development efforts that enable individuals to choose

2 smaller families;

3 ‘‘(2) ensure that all individuals and couples, re4 gardless of age or marital status, are able to exercise

5 their right to decide whether and how many children

6 to have and their right to reproductive health by im7 proving the quality and accessibility of accountable

8 family planning and reproductive health programs;

9 ‘‘(3) improve reproductive health, especially of

10 women and young people, through maternal and

11 child health and nutrition services, and through sex12 uality and gender education services, especially for

13 young people; and

14 ‘‘(4) achieve population stabilization at a level

15 consistent with the maintenance of the natural re16 source base and with investment in human re17 sources, within a broad strategy to adjust consump18 tion levels and patterns in all countries.

19 ‘‘(b) FINANCIAL TARGETS.—The Congress estab20 lishes a target for global expenditures in developing coun21 tries from all domestic and international sources by the

22 year 2000 of at least $11,000,000,000 for population pro23 grams described in section 499C, and establishes a goal

24 for United States population assistance by the year 2000
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1 of $1,400,000,000 in constant 1990 dollars, not including

2 funds available for other reproductive health programs.

3 ‘‘SEC. 499C. AUTHORIZED ACTIVITIES.

4 ‘‘United States population assistance is authorized to

5 provide—

6 ‘‘(1) support for the expansion of quality, af7 fordable, voluntary family planning services, which

8 emphasize informed choice among a variety of safe

9 and effective family planning methods and closely re10 lated reproductive health care services, including the

11 prevention and control of sexually transmitted dis12 eases and reproductive tract infections;

13 ‘‘(2) support for adequate and regular supplies

14 of quality contraceptive and other commodities, com15 prehensive counseling, appropriate followup, and

16 support for programs that emphasize the use of the

17 mass media to improve public knowledge of contra18 ceptive methods and related disease prevention

19 methods and where they may be obtained and to

20 promote the benefits of family planning and repro21 ductive health to individuals, families, and commu22 nities;

23 ‘‘(3) support to United States and foreign re24 search institutions and other appropriate entities for

25 biomedical research to develop and evaluate im-
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1 proved methods of safe and effective contraception

2 and related disease control, with particular emphasis

3 on methods which—

4 ‘‘(A) are likely to be safer, easier to use,

5 easier to make available in developing country

6 settings, and less expensive than current

7 methods;

8 ‘‘(B) are controlled by women, including

9 barrier methods and vaginal microbicides;

10 ‘‘(C) are likely to prevent the spread of

11 sexually transmitted diseases; and

12 ‘‘(D) encourage and enable men to take

13 greater responsibility for their own fertility;

14 ‘‘(4) support for field research on the character15 istics of programs most likely to result in sustained

16 use of effective family planning in meeting each indi17 vidual’s lifetime reproductive goals, with particular

18 emphasis on the perspectives of family planning

19 users, including support for relevant social and be20 havioral research focusing on such factors as the

21 use, non-use, and unsafe or ineffective use of various

22 contraceptive and related-disease control methods;

23 ‘‘(5) support for the development of new evalua24 tion techniques and performance criteria for family
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1 planning programs, emphasizing the family planning

2 user’s perspective and reproductive goals;

3 ‘‘(6) support for research and research dissemi4 nation related to population policy development, in5 cluding demographic and health surveys to assess

6 population trends, measure unmet needs, and evalu7 ate program impact, and support for policy-relevant

8 research on the relationships between population

9 trends, poverty, and environmental management, in10 cluding implications for sustainable agriculture,

11 agroforestry, biodiversity, water resources, energy

12 use, and local and global climate change;

13 ‘‘(7) support for research and public informa14 tion dissemination on the health and welfare con15 sequences of unsafe abortions and for the equipment

16 and training necessary for the medical treatment of

17 the complications of unsafe abortions;

18 ‘‘(8) support for special programs to reach ado19 lescents and young adults, regardless of marital sta20 tus, before they begin childbearing, including health

21 education programs which stress responsible parent22 hood and the health risks of unprotected sexual

23 intercourse, as well as service programs designed to

24 meet the information and contraception needs of

25 adolescents and young adults; and
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1 ‘‘(9) support for a broad array of governmental

2 and nongovernmental communication strategies de3 signed—

4 ‘‘(A) to create public awareness worldwide;

5 ‘‘(B) to generate a consensus on the need

6 to address reproductive health issues and the

7 problems associated with continued world popu8 lation growth;

9 ‘‘(C) to emphasize the need to educate men

10 as well as women and mobilize their support for

11 reproductive rights and responsibilities; and

12 ‘‘(D) to make family planning an estab13 lished community norm.

14 ‘‘SEC. 499D. TERMS AND CONDITIONS.

15 ‘‘United States population assistance is authorized to

16 be provided subject to the following conditions:

17 ‘‘(1) Such assistance may only support, directly

18 or through referral, those activities which provide a

19 broad range of contraceptive methods permitted by

20 individual country policy and a broad choice of pub21 lic and private family planning services, including

22 networks for community-based and subsidized com23 mercial distribution of contraceptives.

24 ‘‘(2) No program supported by United States

25 population assistance may deny an individual family
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1 planning services because of such individual’s inabil2 ity to pay all or part of the cost of such services.

3 ‘‘(3) Family planning services and related re4 productive health care services supported by United

5 States population assistance shall maintain the high6 est medical standards possible under local conditions

7 and shall ensure regular oversight of the quality of

8 medical care and other services offered.

9 ‘‘(4) United States-supported reproductive

10 health programs shall in each recipient country sup11 port to the extent possible an integrated approach,

12 consistent with respect for the rights of women as

13 decisionmakers in matters of reproduction and sexu14 ality, for the provision of public and private repro15 ductive health services.

16 ‘‘(5) United States population assistance pro17 grams shall furnish only those contraceptive drugs

18 and devices which have received approval for mar19 keting in the United States by the Food and Drug

20 Administration or which have been tested and deter21 mined to be safe and effective under research proto22 cols comparable to those required by the Food and

23 Drug Administration or have been determined to be

24 safe by an appropriate international organization or
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1 the relevant health authority in the country to which

2 they are provided.

3 ‘‘(6) Reproductive health services supported by

4 the United States shall be designed to take into ac5 count the needs of individuals and couples, including

6 the constraints on women’s time, by involving com7 munities, particularly representatives of women,

8 through appropriate training and recruitment ef9 forts, in the design, management, and ongoing eval10 uation of services. The design of such services shall

11 stress easy accessibility, by locating services as close

12 as possible to potential users, by keeping hours of

13 service convenient, and by improving communica14 tions between users and providers through commu15 nity outreach and involvement. The evaluation of re16 productive health services also shall not use as a

17 measure of program success the degree of longevity

18 or permanency of any contraceptive method.

19 ‘‘(7) United States population assistance to ad20 olescent fertility programs shall be provided in the

21 context of prevailing norms and customs in the re22 cipient country.

23 ‘‘(8) None of the funds made available by the

24 United States Government to foreign governments,

25 international organizations, or nongovernmental or-
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1 ganizations may be used to coerce any person to un2 dergo contraceptive sterilization or involuntary abor3 tion or to accept any other method of fertility

4 control.

5 ‘‘SEC. 499E. ELIGIBILITY FOR POPULATION ASSISTANCE.

6 ‘‘(a) ELIGIBLE COUNTRIES.—Notwithstanding any

7 other provision of law, United States population assistance

8 shall be available, directly or through intermediary organi9 zations, to any country which the President determines

10 has met one or more of the following criteria:

11 ‘‘(1) The country accounts for a significant pro12 portion of the world’s annual population increment.

13 ‘‘(2) The country has significant unmet needs

14 for methods of contraception, prevention and treat15 ment of sexually transmitted diseases and acquired

16 immune deficiency syndrome (AIDS), and obstetric

17 and gynecological care, and requires foreign assist18 ance to directly implement, expand, or sustain qual19 ity reproductive health services for all its people.

20 ‘‘(3) The country demonstrates a strong com21 mitment to population stabilization and to com22 prehensive reproductive health care strategies

23 through policies, programs and the commitment of

24 domestic funds to improve service and make services

25 more widely available.
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1 ‘‘(b) ELIGIBILITY OF NONGOVERNMENTAL AND MUL2 TILATERAL ORGANIZATIONS.—In determining eligibility

3 for United States population assistance, the President

4 shall not subject nongovernmental and multilateral organi5 zations to requirements which are more restrictive than

6 requirements applicable to foreign governments for such

7 assistance.

8 ‘‘SEC. 499F. PARTICIPATION IN MULTILATERAL ORGANIZA9 TIONS.

10 ‘‘(a) FINDING.—The Congress recognizes that the re11 cent attention in government policies toward population

12 stabilization owes much to the efforts of the United Na13 tions and its specialized agencies and organizations, par14 ticularly the United Nations Population Fund.

15 ‘‘(b) AVAILABILITY OF FUNDS.—United States popu16 lation assistance shall be available for contributions to the

17 United Nations Population Fund in such amounts as the

18 President determines would be commensurate with United

19 States contributions to other multilateral organizations

20 and with the contributions of other donor countries.

21 ‘‘(c) PROHIBITIONS.—(1) The prohibitions contained

22 in section 104(f) of this Act shall apply to the funds made

23 available for the United Nations Population Fund.

24 ‘‘(2) No United States population assistance may be

25 available to the United Nations Population Fund unless
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1 such assistance is held in a separate account and not com2 mingled with any other funds.

3 ‘‘(3) No funds may be available for the United Na4 tions Population Fund unless the Fund agrees to prohibit

5 the use of those funds to carry out any program, project,

6 or activity that involves the use of coerced abortion or in7 voluntary sterilization.

8 ‘‘(d) ALLOCATION OF FUNDS.—Of the funds made

9 available for United States population assistance, the

10 President shall make available for the Special Programme

11 of Research, Development and Research Training in

12 Human Reproduction for each of the fiscal years 1994 and

13 1995 an amount commensurate with the contributions of

14 the other donor countries for the purpose of furthering

15 international cooperation in the development and evalua16 tion of contraceptive technology.

17 ‘‘SEC. 499G. SUPPORT FOR NONGOVERNMENTAL ORGANIZA18 TIONS.

19 ‘‘(a) FINDINGS.—The Congress finds that—

20 ‘‘(1) in many developing countries, nongovern21 mental entities, including private and voluntary or22 ganizations and private sector entities, such as the

23 International Planned Parenthood Federation and

24 the Planned Parenthood Federation of America, are

25 the most appropriate and effective providers of Unit-
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1 ed States assistance to population and family plan2 ning activities; and

3 ‘‘(2) in particular, organizations and groups

4 founded by women or in which women have signifi5 cant and meaningful participation, and which are

6 committed to promoting women’s reproductive health

7 rights through client-oriented programs and activi8 ties, have proven the most effective of all.

9 ‘‘(b) PROCEDURES.—The President shall establish

10 simplified procedures for the development and approval of

11 programs to be carried out by nongovernmental organiza12 tions that have demonstrated—

13 ‘‘(1) a capacity to undertake quality, effective,

14 client-oriented reproductive health and population

15 activities which encourage significant involvement by

16 private health practitioners, employer-based health

17 services, unions, and cooperative health organiza18 tions; and

19 ‘‘(2) a commitment to quality, client-oriented

20 reproductive health care for women.

21 ‘‘(c) PRIORITY FOR NONGOVERNMENTAL ORGANIZA22 TIONS.—The largest share of United States population as23 sistance made available for any fiscal year shall be made

24 available through United States and foreign nongovern25 mental organizations.
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1 ‘‘SEC. 499H. REPORTS TO CONGRESS.

2 ‘‘The President shall prepare and submit to the Con3 gress, as part of the annual presentation materials on for4 eign assistance, a report on world progress toward popu5 lation stabilization and universal reproductive choice. The

6 report shall include—

7 ‘‘(1) estimates of expenditures on the popu8 lation activities described in section 499C by na9 tional governments, donor agencies, and private sec10 tor entities;

11 ‘‘(2) an assessment by country of the availabil12 ity and use of all methods of contraception and

13 abortion, whether lawful or unlawful in that country;

14 ‘‘(3) an analysis by country and region of the

15 impact of population trends on a set of key social,

16 economic, political, and environmental indicators,

17 which shall be identified by the President in the first

18 report submitted pursuant to this section and ana19 lyzed in that report and each subsequent report; and

20 ‘‘(4) a detailed statement of prior year and pro21 posed direct and indirect allocations of population

22 assistance, by country, which describes how each

23 country allocation meets the criteria set forth in this

24 section.’’.
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1 SEC. 3. AUTHORIZATIONS OF APPROPRIATIONS.

2 Section 104(g)(1) of the Foreign Assistance Act of

3 1961 (22 U.S.C. 2151b(g)(1) is amended by amending

4 subparagraph (A) to read as follows:

5 ‘‘(A) $725,000,000 for fiscal year 1994 and

6 $800,000,000 for fiscal year 1995 to carry out sub7 section (b) of this section; and’’.

8 SEC. 4. ECONOMIC AND SOCIAL DEVELOPMENT INITIA9 TIVES TO STABILIZE WORLD POPULATION.

10 (a) CONGRESSIONAL FINDINGS.—The Congress

11 makes the following findings:

12 (1) Women represent 50 percent of the world’s

13 human resource potential. Therefore, improving the

14 health, social, and economic status of women and in15 creasing their productivity are essential for economic

16 progress in all countries.

17 (2) Throughout the world, women who partici18 pate in the social, economic, and political affairs of

19 their communities are more likely to exercise their

20 choice about childbearing than women who do not

21 participate in such activities.

22 (3) Effective economic development strategies

23 address issues such as infant and child survival

24 rates, educational opportunities, especially literacy

25 programs, for girls and women, and gender equality

26 in development.
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1 (4) Comprehensive population stabilization ef2 forts which include both family planning services

3 and economic development activities achieve lower

4 birth rates and stimulate more development than

5 those which pursue these objectives independently.

6 (5) The most powerful, long-term influence on

7 birthrates is education, especially educational attain8 ment among women. The education of women also

9 has a strong influence on other aspects of family

10 welfare, including child survival. World-wide statis11 tics, however, indicate that the number of school-age

12 children, especially girls, not attending school is

13 growing annually.

14 (6) Each year, nearly 15,000,000 children

15 under the age of 5 die, most from preventable

16 causes. Wider availability of vaccines, simple treat17 ments for diarrheal disease and respiratory infec18 tions, and improved nutrition could prevent many of

19 these deaths.

20 (7) Each year, 500,000 or more women world21 wide die from complications related to pregnancy,

22 childbirth, or illegal abortion. Another 10 million

23 women annually suffer long-term illness or perma24 nent physical impairment from such causes.
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1 (8) In many countries, high levels of mortality

2 and morbidity among women of childbearing age are

3 directly related to inadequate or inaccessible repro4 ductive health care services.

5 (9) Many women are their family’s principal

6 caregiver and chief source of economic support. The

7 death of a mother substantially increases the risk of

8 neglect, abandonment, or death for her young

9 children.

10 (10) Malnutrition and anemia are widespread

11 among poor women in their childbearing years, yet

12 the worldwide campaign to encourage breastfeeding

13 has devoted little attention to the nutritional needs

14 of nursing mothers, or in the improvement of nutri15 tional and health levels of women in general.

16 (11) During the 1990s, women, especially in

17 Africa, face substantially increased risks of death or

18 disability from sexually transmitted diseases. During

19 the 1990s, more than 3,000,000 women in Africa

20 will die of the acquired immune deficiency syndrome

21 (AIDS), leaving more than 5,000,000 orphans.

22 (b) DECLARATION OF POLICY.—Congress declares

23 that, in order to further the United States foreign policy

24 objective of assisting the international community in

25 achieving universal availability of quality family planning
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1 services and stabilizing world population, additional objec2 tives of the foreign policy of the United States shall be—

3 (1) to expand basic education opportunities for

4 girls and women;

5 (2) to reduce the gap between male and female

6 levels of literacy and between male and female levels

7 of primary and secondary school enrollment;

8 (3) to help ensure that women worldwide have

9 the opportunity to become equal partners with men

10 in the development of their societies;

11 (4) to reduce global maternal and infant mor12 tality rates; and

13 (5) to improve worldwide overall reproductive

14 health, maternal and child health status, and quality

15 of life.

16 (c) AUTHORIZED ACTIVITIES.—United States devel17 opment assistance shall be available, on a priority basis,

18 for—

19 (1) countries which either have adopted and im20 plemented, or have agreed to adopt and implement,

21 strategies to help ensure, by the year 2000—

22 (A) the completion of primary school edu23 cation by no less than 80 percent of the coun24 try’s primary school-age children;
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1 (B) the reduction of adult illiteracy by at

2 least one-half the country’s 1990 level; and

3 (C) the elimination of the gap between

4 male and female levels of literacy and between

5 male and female levels of primary and second6 ary school enrollment;

7 (2) governmental and nongovernmental pro8 grams which, with respect to a targeted country, are

9 intended—

10 (A) to reduce significantly malnutrition

11 among the country’s children under 5 years of

12 age;

13 (B) to maintain immunizations against

14 childhood diseases for significant segments of

15 the country’s children; and

16 (C) to reduce the number of childhood

17 deaths in the country which result from diar18 rheal disease and acute respiratory infections;

19 (3) governmental and nongovernmental pro20 grams which are intended to increase women’s pro21 ductivity through improved access to appropriate

22 labor-saving technology, vocational training, and ex23 tension services and access to credit and child care;

24 and
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1 (4) governmental and nongovernmental pro2 grams which are intended to increase the access of

3 girls and women to comprehensive reproductive

4 health care services pursuant to subsection (d).

5 (d) SAFE MOTHERHOOD INITIATIVE.—(1)(A) The

6 President is authorized to establish a grant program, to

7 be known as the Safe Motherhood Initiative, to help im8 prove the access of girls and women worldwide to com9 prehensive reproductive health care services.

10 (B) Such program shall be carried out in accordance

11 with this section and shall be subject to the same terms,

12 conditions, prohibitions, and restrictions as are applicable

13 to assistance made available under sections 499D, 499E,

14 and 499F of the Foreign Assistance Act of 1961.

15 (2) Eligible for assistance under this section are com16 prehensive reproductive health programs which empha17 size—

18 (A) contraceptive services;

19 (B) prenatal care and screening for high risk

20 pregnancies, and improved access to safe delivery

21 services for women with high risk pregnancies;

22 (C) supplemental food programs for pregnant

23 and nursing women;

24 (D) expanded and coordinated programs to pre25 vent, detect, and treat sexually transmitted diseases,
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1 including acquired immune deficiency syndrome

2 (AIDS), reproductive tract infections, and other

3 chronic reproductive health problems;

4 (E) programs to eliminate traditional practices

5 injurious to women’s health, including female genital

6 mutilation; and

7 (F) improvements in the practice of midwifery,

8 including outreach to traditional birth attendants.

9 (e) REPORTS TO CONGRESS.—(1) Not later than De10 cember 31, 1994, the President shall prepare and submit

11 to the Congress a report which includes—

12 (A) estimates of the total financial resources

13 needed to achieve, by the year 2000, the specific ob14 jectives set forth in subsection (c) with respect to

15 education, rates of illiteracy, malnutrition, immuni16 zation, maternal and child mortality and morbidity,

17 and improvements in the economic productivity of

18 women;

19 (B) an analysis of such estimates which sepa20 rately lists the total financial resources needed from

21 the United States, other donor nations, and non-gov22 ernmental organizations;

23 (C) an analysis, by country, which—

24 (i) identifies the legal, social, economic,

25 and cultural barriers to women’s self-determina-
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1 tion and to improvements in the economic pro2 ductivity of women in traditional and modern

3 labor sectors; and

4 (ii) describes initiatives needed to develop

5 appropriate technologies for use by women,

6 credit programs for low-income women, ex7 panded child care, vocational training, and ex8 tension services for women; and

9 (D) a comprehensive description of—

10 (i) new and expanded initiatives to ensure

11 safe motherhood worldwide;

12 (ii) findings on the major causes of mortal13 ity and morbidity among women of childbearing

14 age in various regions of the world;

15 (iii) actions needed to reduce, by the year

16 2000, world maternal mortality by one-half of

17 the worldwide 1990 level; and

18 (iv) the financial resources needed to meet

19 this goal from the United States, other donor

20 nations, and nongovernmental organizations.

21 (2) In each annual country human rights report, the

22 Secretary of State shall include—

23 (A) information on any patterns within the

24 country of discrimination against women in in25 heritance laws, property rights, family law, ac-
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1 cess to credit and technology, hiring practices,

2 formal education, and vocational training; and

3 (B) an assessment which makes reference

4 to all significant forms of violence against

5 women, including rape, domestic violence, and

6 female genital mutilation, the extent of involun7 tary marriage and childbearing, and the preva8 lence of marriage among women under the age

9 of 18 years.

10 (f) AUTHORIZATION OF APPROPRIATIONS.—(1) Of

11 the aggregate amounts available for United States devel12 opment and economic assistance programs for education

13 activities, $350,000,000 for fiscal year 1994 and

14 $350,000,000 for fiscal year 1995 shall be available only

15 for programs in support of equalizing male and female lev16 els of primary and secondary school enrollment.

17 (2) There are authorized to be appropriated

18 $405,000,000 for fiscal year 1994 and $490,000,000 for

19 fiscal year 1995 to the Child Survival Fund under section

20 104(c)(2) of the Foreign Assistance Act of 1961, which

21 amounts shall be available for child survival activities only,

22 including the Children’s Vaccine Initiative, the worldwide

23 immunization effort, and oral rehydration programs.
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1 (3) There are authorized to be appropriated

2 $100,000,000 for the Safe Motherhood Initiative for each

3 of fiscal years 1994 and 1995.

4 (g) DEFINITIONS.—For purposes of this section—

5 (1) the term ‘‘annual country human rights re6 port’’ refers to the report required to be submitted

7 pursuant to section 502B(b) of the Foreign Assist8 ance Act of 1961 (22 U.S.C. 2304(b)); and

9 (2) the term ‘‘United States development and

10 economic assistance’’ means assistance made avail11 able under chapter 1 of part I and chapter 4 of part

12 II of the Foreign Assistance Act of 1961.

13 SEC. 5. AIDS PREVENTION AND CONTROL FUND.

14 (a) IN GENERAL.—Section 104(c) of the Foreign As15 sistance Act of 1961 (22 U.S.C. 2151b(c)) is amended by

16 adding at the end the following new paragraph:

17 ‘‘(4)(A)(i) The President is authorized to provide as18 sistance, under such terms and conditions as he may de19 termine, with respect to activities relating to research on,

20 and the treatment and control of, acquired immune defi21 ciency syndrome (AIDS) in developing countries.

22 ‘‘(ii) Assistance provided under clause (i) shall in23 clude—

24 ‘‘(I) funds made available directly to the World

25 Health Organization for its use in financing the
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1 Global Program on AIDS (including activities imple2 mented by the Pan American Health Organization);

3 and

4 ‘‘(II) funds made available to the United Na5 tions Children’s Fund (UNICEF) for AIDS-related

6 activities.

7 ‘‘(B) Appropriations pursuant to subparagraph (A)

8 may be referred to as the ‘AIDS Prevention and Control

9 Fund’.’’.

10 (b) AUTHORIZATION OF APPROPRIATIONS.—Section

11 104(g)(1) of the Foreign Assistance Act of 1961 (22

12 U.S.C. 2151b(g)) is amended—

13 (1) by striking ‘‘and’’ at the end of subpara14 graph (A);

15 (2) in subparagraph (B), by striking ‘‘sub16 section (c) of this section.’’ and inserting ‘‘sub17 section (c) of this section (other than paragraph (4)

18 thereof); and’’; and

19 (3) by adding at the end thereof the following

20 new subparagraph:

21 ‘‘(C) $100,000,000 for fiscal year 1994

22 and $165,000,000 for fiscal year 1995 to carry

23 out subsection (c)(4) of this section.’’.

24 (c) EFFECTIVE DATE.—The amendments made by

25 this section shall take effect October 1, 1993.
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1 SEC. 6. OVERSIGHT OF MULTILATERAL DEVELOPMENT

2 BANKS.

3 (a) FINDING.—The Congress considers insufficient

4 the role currently played in global population efforts by

5 the International Bank for Reconstruction and Develop6 ment, the Asian Development Bank, the Inter-American

7 Development Bank and the African Development Bank.

8 Although these multilateral development banks are sin9 gularly important sources of support for development ac10 tivities, together they provided less than $200,000,000 in

11 1990 in assistance for core population programs. Nor have

12 these institutions consistently encouraged appropriate

13 population and reproductive health care policies.

14 (b) REPORT REQUIRED.—(1) The Congress believes

15 that the multilateral development banks should together

16 increase their support for the population activities de17 scribed in section 499C of the Foreign Assistance Act of

18 1961 to no less than $1,000,000,000 by the end of 1999.

19 (2) Not later than July 31 of each year, the United

20 States Executive Directors of the International Bank for

21 Reconstruction and Development, the Asian Development

22 Bank, the Inter-American Development Bank and the Af23 rican Development Bank shall prepare and transmit to

24 Congress a report which sets forth information on alloca25 tions by each of these institutions to the population activi26 ties described in section 499C of the Foreign Assistance
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1 Act of 1961 and, if such allocations total less than

2 $1,000,000,000, set forth any specific actions taken by the

3 Executive Directors to encourage increases in such alloca4 tions and in policy level discussions with donor and devel5 oping country governments.

6 SEC. 7. COMMISSION ON WORLD POPULATION STABILIZA7 TION AND REPRODUCTIVE HEALTH.

8 (a) ESTABLISHMENT OF COMMISSION.—There is es9 tablished the Commission on World Population Stabiliza10 tion and Reproductive Health for the purpose of coordi11 nating United States preparation for, and participation in,

12 the 1994 International Conference on Population and De13 velopment and for other purposes.

14 (b) COMPOSITION OF COMMISSION.—The Commis15 sion shall be composed of—

16 (1) the Under Secretary of State for Global

17 Population, Environment and National Resources;

18 (2) the Administrator of the Agency for Inter19 national Development;

20 (3) the Deputy Assistant Secretary for Popu21 lation Affairs of the Department of Health and

22 Human Services;

23 (4) the Assistant Administrator for Inter24 national Activities of the Environmental Protection

25 Agency;
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1 (5) the Director of the Congressional Office of

2 Technology Assessment; and

3 (6) three individuals appointed by the Presi4 dent, by and with the advice and consent of the Sen5 ate, one of whom the President shall designate as

6 Chairman.

7 (c) PERIOD OF APPOINTMENT; VACANCIES.—Mem8 bers shall be appointed for the life of the Commission. Any

9 vacancy in the Commission shall not affect its powers, but

10 shall be filled in the same manner as the original appoint11 ment.

12 (d) QUORUM.—A majority of the members of the

13 Commission shall constitute a quorum, but a lesser num14 ber of members may hold hearings.

15 (e) HEARINGS.—The Commission may hold such

16 hearings, sit and act at such times and places, take such

17 testimony, and receive such evidence as the Commission

18 considers advisable to carry out the purposes of this sec19 tion.

20 (f) INFORMATION FROM FEDERAL AGENCIES.—The

21 Commission may secure directly from any Federal depart22 ment or agency such information as the Commission con23 siders necessary to carry out the provisions of this Act.

24 Upon request of the Chairman of the Commission, the
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1 head of such department or agency shall furnish such in2 formation to the Commission.

3 (g) POSTAL SERVICES.—The Commission may use

4 the United States mails in the same manner and under

5 the same conditions as other departments and agencies of

6 the Federal Government.

7 (h) GIFTS.—The Commission may accept, use, and

8 dispose of gifts or donations of services or property.

9 (i) COMPENSATION OF MEMBERS.—Each member of

10 the Commission who is not an officer or employee of the

11 Federal Government shall be compensated at a rate equal

12 to the daily equivalent of the annual rate of basic pay pre13 scribed for level IV of the Executive Schedule under sec14 tion 5315 of title 5, United States Code, for each day (in15 cluding travel time) during which such member is engaged

16 in the performance of the duties of the Commission. All

17 members of the Commission who are officers or employees

18 of the United States shall serve without compensation in

19 addition to that received for their services as officers or

20 employees of the United States.

21 (j) TRAVEL EXPENSES.—The members of the Com22 mission shall be allowed travel expenses, including per

23 diem in lieu of subsistence, at rates authorized for employ24 ees of agencies under subchapter I of chapter 57 of title

25 5, United States Code, while away from their homes or
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1 regular places of business in the performance of services

2 for the Commission.

3 (k) STAFF COMPENSATION.—The Chairman of the

4 Commission may fix the compensation of personnel with5 out regard to the provisions of chapter 51 and subchapter

6 III of chapter 53 of title 5, United States Code, relating

7 to classification of positions and General Schedule pay

8 rates, except that the rate of pay for the executive director

9 and other personnel may not exceed the rate payable for

10 level V of the Executive Schedule under section 5316 of

11 such title.

12 (l) DETAIL OF GOVERNMENT EMPLOYEES.—Any

13 Federal Government employee may be detailed to the

14 Commission without reimbursement, and such detail shall

15 be without interruption or loss of civil service status or

16 privilege.

17 (m) PROCUREMENT OF TEMPORARY AND INTERMIT18 TENT SERVICES.—The Chairman of the Commission may

19 procure temporary and intermittent services under section

20 3109(b) of title 5, United States Code, at rates for individ21 uals which do not exceed the daily equivalent of the annual

22 rate of basic pay prescribed for level V of the Executive

23 Schedule under section 5316 of such title.

24 (n) REPORT.—Not later than June 30, 1994, the

25 Commission shall submit to the President a public report
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1 on national and international population trends and the

2 probable impact of such trends on efforts to alleviate pov3 erty and protect the environment. The report, which

4 should be made available for consideration at the 1994

5 International Conference on Population and Development,

6 shall specify, among other things, modifications in policy

7 and financial commitments required by foreign govern8 ments to achieve universal reproductive choice and early

9 population stabilization.

10 (o) TERMINATION OF THE COMMISSION.—The Com11 mission shall terminate 90 days after the date on which

12 the Commission submits its report under subsection (n).

13 (p) AUTHORIZATION OF APPROPRIATIONS.—To carry

14 out this section, there are authorized to be appropriated

15 to the Commission $1,000,000 for fiscal year 1994.

16 SEC. 8. SUPPORT FOR UNITED NATIONS FORWARD LOOK17 ING STRATEGIES FOR THE ADVANCEMENT OF

18 WOMEN.

19 (a) IN GENERAL.—The President shall direct the

20 United States representatives to the United Nations Com21 mission on the Status of Women to take all actions nec22 essary to ensure the rapid implementation of the United

23 Nations Forward Looking Strategies for the Advancement

24 of Women, as adopted in 1985 at the United Nations Con25 ference ending the Decade for Women.
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1 (b) REVIEW AND ANNUAL REPORTS.—Not later than

2 December 31, 1993, the Secretary of State shall submit

3 the 5-year review of the status of United States women,

4 as called for at the conference, and shall submit such an5 nual reports as are requested by the United Nations Com6 mission on the Status of Women.

7 SEC. 9. SUPPORT FOR THE CONVENTION ON THE ELIMI8 NATION OF ALL FORMS OF DISCRIMINATION

9 AGAINST WOMEN.

10 The President shall promptly complete the review of

11 the United Nations Convention on the Elimination of All

12 Forms of Discrimination Against Women, which was

13 signed by the United States on July 17, 1980, and submit

14 to the Senate any reservations, understandings, or dec15 larations that the President considers necessary in order

16 that the Senate may give its advice and consent to ratifica17 tion, or report to the Congress why he is unable or unwill18 ing to do so.

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