I 
110TH CONGRESS 
1ST SESSION H. R. 2266 
To provide assistance to improve the health of newborns, children, and 
mothers in developing countries, and for other purposes. 
IN THE HOUSE OF REPRESENTATIVES 
MAY 10, 2007 
Ms. MCCOLLUM of Minnesota (for herself, Mr. SHAYS, Mr. PAYNE, Mr. 
REICHERT, Mr. BLUMENAUER, Mr. CROWLEY, Mr. ELLISON, Mr. 
GRIJALVA, Mr. HONDA, Ms. JACKSON-LEE of Texas, Mr. JEFFERSON, 
Mr. MCDERMOTT, Mr. MCGOVERN, Mr. OLVER, Mr. SNYDER, Ms. WAT-
SON, and Ms. WOOLSEY) introduced the following bill; which was referred 
to the Committee on Foreign Affairs 
A BILL 
To provide assistance to improve the health of newborns, 
children, and mothers in developing countries, and for 
other purposes. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘United States Commit-
ment to Global Child Survival Act of 2007’’. 
SEC. 2. FINDINGS AND PURPOSES. 
(a) FINDINGS.—Congress finds the following: 
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(1) The significant commitment of the United 
States to reducing child mortality in the developing 
world contributed to a 50 percent reduction in the 
mortality of children under the age of 5 between 
1960 and 1990. 
(2) The United States Agency for International 
Development’s support for child survival interven-
tions and technologies during the 1970s and 1980s 
saves the lives of millions of children each year. 
(3) Since 1990 significant progress in child sur-
vival has been made, including substantial reduc-
tions in child mortality in Egypt (68 percent), Nepal 
(49 percent), and Malawi (43 percent). 
(4) While United States investments in child 
survival has contributed to a major decline in the 
rate of child mortality, 10.1 million children under 
the age of 5 die each year, over 28,000 children per 
day, from easily preventable and treatable causes. 
(5) Four million newborns die in the first 4 
weeks of life, which accounts for 38 percent of all 
deaths of children under the age of 5. 
(6) Ninety percent of deaths of children under 
the age of 5 occur in just 42 countries. 
(7) According to the Lancet, 67 percent of neo-
natal deaths take place in just 10 countries: India, 
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China, Pakistan, Nigeria, Bangladesh, Ethiopia, the 
Democratic Republic of the Congo, Indonesia, Af-
ghanistan, and the United Republic of Tanzania. 
(8) According to the Lancet, maternal health is 
an important determinant of neonatal survival with 
maternal death increasing death rates for newborns 
to as high as 100 percent in poor countries. 
(9) Approximately 525,000 women die every 
year in the developing world from causes related to 
pregnancy and childbirth. 
(10) Poverty is the root cause of many mater-
nal and neonatal deaths, either because it increases 
the prevalence of risk factors or because it reduces 
access to care. 
(11) Risk factors for maternal death in devel-
oping countries include pregnancy and childbirth at 
an early age, closely-spaced births, infectious dis-
eases, malnutrition, and complications during child-
birth. 
(12) Skilled birth attendants, access to preven-
tive care, and child spacing can reduce maternal 
mortality and increase child survival rates. 
(13) A package of 20 affordable interventions, 
including skilled care at birth, emergency obstetric 
care, breastfeeding, vaccinations, antibiotics, and 
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micro-nutrients, could save 6 million children per 
year at a cost of only $25 per child or $1.62 per 
person in 60 priority countries. 
(14) Millions of children’s lives can be saved by 
high-impact, low-cost, feasible interventions like oral 
rehydration therapy (ORT) for diarrhea ($0.06 per 
treatment), antibiotics to treat respiratory infections 
($0.25 per treatment), and anti-malaria tablets 
($0.12 per treatment). 
(15) Three million children die each year due to 
lack of access to low-cost antibiotics and anti-malar-
ial drugs. 
(16) Lack of access to health services results in 
30 million children under the age of 1 year going 
without necessary immunizations and 1.7 million 
children dying from diseases in which vaccines are 
readily available. 
(17) During the 1990s, successful immuniza-
tion programs reduced polio by 99 percent, tetanus 
deaths by 50 percent, and measles cases by 40 per-
cent. 
(18) Between 1999 and 2004, distribution of 
low-cost vitamin A supplements saved an estimated 
2.3 million lives, yet the unmet need for vitamin A 
supplements results in an estimated 250,000 to 
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500,000 children becoming blind each year, with 70 
percent of such children dying within 12 months of 
losing their sight. 
(19) 
Exclusive 
breastfeeding—giving 
only 
breast milk for the first 6 months of life—could pre-
vent an estimated 1.3 million newborn and infant 
deaths each year, primarily by protecting against di-
arrhea and pneumonia. 
(20) Two million lives could be saved annually 
by providing oral-rehydration therapy prepared with 
clean water. 
(21) Expansion of clinical care of newborns and 
mothers, such as clean delivery by skilled attendants, 
emergency obstetric care, and neonatal resuscitation, 
can avert 50 percent of newborn deaths. 
(22) The United Nations Children’s Fund 
(UNICEF), with support from the World Health Or-
ganization, the World Bank, and the African Union, 
has successfully demonstrated the accelerated child 
survival and development program in Senegal, Mali, 
Benin, and Ghana, reducing mortality of children 
under the age of 5 by 20 percent in targeted areas 
using low-cost, high-impact interventions. 
(23) In 2000, the United States joined 188 
other countries in supporting 8 United Nations Mil-
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lennium Development Goals, including goals to re-
duce the mortality rate of children under the age of 
5 by two-thirds and reduce maternal deaths by 
three-quarters by 2015. 
(24) On September 14, 2005, President George 
W. Bush stated before the leaders of the world: ‘‘To 
spread a vision of hope, the United States is deter-
mined to help nations that are struggling with pov-
erty. We are committed to the Millennium Develop-
ment Goals.’’. 
(b) PURPOSES.—The purposes of this Act are to— 
(1) authorize assistance to reduce mortality and 
improve the health of newborns, children, and moth-
ers in developing countries, including strengthening 
the capacity of health systems and health workers; 
(2) develop and implement a strategy to reduce 
mortality and improve the health of newborns, chil-
dren, and mothers in developing countries; and 
(3) establish a task force to assess, monitor, 
and evaluate the progress and contributions of rel-
evant departments and agencies of the Government 
of the United States in achieving the United Nations 
Millennium Development Goals by 2015 for reducing 
the mortality of children under the age of 5 by two- 
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thirds and reducing maternal mortality by three- 
quarters in developing countries. 
SEC. 3. ASSISTANCE TO REDUCE MORTALITY AND IMPROVE 
THE HEALTH OF NEWBORNS, CHILDREN, AND 
MOTHERS IN DEVELOPING COUNTRIES. 
(a) IN GENERAL.—Chapter 1 of part I of the Foreign 
Assistance Act of 1961 (22 U.S.C. 2151 et seq.) is amend-
ed— 
(1) in section 104(c)— 
(A) by striking paragraphs (2) and (3); 
and 
(B) by redesignating paragraph (4) as 
paragraph (2); 
(2) by redesignating sections 104A, 104B, and 
104C as sections 104B, 104C, and 104D, respec-
tively; and 
(3) by inserting after section 104 the following 
new section: 
‘‘SEC. 104A. ASSISTANCE TO REDUCE MORTALITY AND IM-
PROVE THE HEALTH OF NEWBORNS, CHIL-
DREN, AND MOTHERS. 
‘‘(a) 
AUTHORIZATION.—Consistent 
with 
section 
104(c), the President is authorized to furnish assistance, 
on such terms and conditions as the President may deter-
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mine, to reduce mortality and improve the health of 
newborns, children, and mothers in developing countries. 
‘‘(b) ACTIVITIES SUPPORTED.—Assistance provided 
under subsection (a) shall, to the maximum extent prac-
ticable, be used to carry out the following: 
‘‘(1) Activities to improve newborn care and 
treatment. 
‘‘(2) Activities to treat childhood illness, includ-
ing increasing access to and utilization of appro-
priate treatment for diarrhea, pneumonia, and other 
life-threatening childhood illnesses. 
‘‘(3) Activities to improve child and maternal 
nutrition, including the delivery of iron, zinc, vita-
min A, iodine, and other key micronutrients and the 
promotion of breastfeeding. 
‘‘(4) Activities to strengthen the delivery of im-
munization services, including efforts to eliminate 
polio. 
‘‘(5) Activities to improve birth preparedness 
and maternity services. 
‘‘(6) Activities to improve the recognition and 
treatment of obstetric complications and disabilities. 
‘‘(7) Activities to improve household-level be-
havior related to safe water, hygiene, exposure to in-
door smoke, and environmental toxins such as lead. 
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‘‘(8) Activities to improve capacity for health 
governance, finance and workforce, including sup-
port for training clinicians, nurses, technicians, sani-
tation and public health workers, community-based 
health workers, midwives, birth attendants, peer 
educators, volunteers, and private sector enterprises. 
‘‘(9) Activities to address antimicrobial resist-
ance in child and maternal health. 
‘‘(10) Activities to establish and support host 
country institutions’ management information sys-
tems and the development and use of tools and mod-
els to collect, analyze, and disseminate information 
related to newborn, child, and maternal health. 
‘‘(11) Activities to develop and conduct needs 
assessments, baseline studies, targeted evaluations, 
or other information-gathering efforts for the design, 
monitoring, and evaluation of newborn, child, and 
maternal health efforts. 
‘‘(12) Activities to integrate and coordinate as-
sistance provided under this section with existing 
health programs for— 
‘‘(A) the prevention of the transmission of 
HIV from mother-to-child and other HIV/AIDS 
counseling, care, and treatment activities; 
‘‘(B) malaria; 
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‘‘(C) tuberculosis; and 
‘‘(D) child spacing. 
‘‘(c) GUIDELINES.—To the maximum extent prac-
ticable, programs, projects, and activities carried out using 
assistance provided under this section shall be— 
‘‘(1) carried out through private and voluntary 
organizations, including faith-based organizations, 
and relevant international and multilateral organiza-
tions, including the GAVI Alliance (formerly known 
as the Global Alliance for Vaccines and Immuniza-
tion) and the United Nations Children’s Fund 
(UNICEF), giving priority to organizations that 
demonstrate effectiveness and commitment to im-
proving the health of newborns, children, and moth-
ers; 
‘‘(2) carried out with input by host countries, 
including civil society and local communities, as well 
as other donors and multilateral organizations; 
‘‘(3) carried out with input by beneficiaries and 
other directly-affected populations, especially women 
and marginalized communities; and 
‘‘(4) designed to build the capacity of host 
country governments and civil society organizations. 
‘‘(d) ANNUAL REPORT.—Not later than January 31 
of each year, the President shall transmit to Congress a 
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report on the implementation of this section for the prior 
fiscal year. 
‘‘(e) DEFINITIONS.—In this section: 
‘‘(1) AIDS.—The term ‘AIDS’ has the meaning 
given the term in section 104B(g)(1) of this Act. 
‘‘(2) HIV.—The term ‘HIV’ has the meaning 
given the term in section 104B(g)(2) of this Act. 
‘‘(3) HIV/AIDS.—The term ‘HIV/AIDS’ has 
the meaning given the term in section 104B(g)(3) of 
this Act.’’. 
(b) CONFORMING AMENDMENTS.—The Foreign As-
sistance Act of 1961 (22 U.S.C. 2151 et seq.) is amend-
ed— 
(1) in section 104(c)(2) (as redesignated by 
subsection (a)(1)(B) of this section), by striking 
‘‘and 104C’’ and inserting ‘‘104C, and 104D’’; 
(2) in section 104B (as redesignated by sub-
section (a)(2) of this section)— 
(A) in subsection (c)(1), by inserting ‘‘and 
section 104A’’ after ‘‘section 104(c)’’; 
(B) in subsection (e)(2), by striking ‘‘sec-
tion 104B, and section 104C’’ and inserting 
‘‘section 104C, and section 104D’’; and 
(C) in subsection (f), by striking ‘‘section 
104(c), this section, section 104B, and section 
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104C’’ and inserting ‘‘section 104(c), section 
104A, this section, section 104C, and section 
104D’’; 
(3) in subsection (c) of section 104C (as redes-
ignated by subsection (a)(2) of this section), by in-
serting ‘‘and section 104A’’ after ‘‘section 104(c)’’; 
(4) in subsection (c) of section 104D (as redes-
ignated by subsection (a)(2) of this section), by in-
serting ‘‘and section 104A’’ after ‘‘section 104(c)’’; 
(5) in the first sentence of section 119(c), by 
striking ‘‘section 104(c)(2), relating to Child Sur-
vival Fund’’ and inserting ‘‘section 104A’’; and 
(6) in section 135(b)— 
(A) in paragraph (1), by striking ‘‘section 
104A(g)(1)’’ 
and 
inserting 
‘‘section 
104B(g)(1)’’; and 
(B) in paragraph (3), by striking ‘‘section 
104A(g)(3)’’ 
and 
inserting 
‘‘section 
104B(g)(3)’’. 
SEC. 4. STRATEGY TO REDUCE MORTALITY AND IMPROVE 
THE HEALTH OF NEWBORNS, CHILDREN, AND 
MOTHERS IN DEVELOPING COUNTRIES. 
(a) STRATEGY REQUIRED.—The President shall de-
velop and implement a comprehensive United States Gov-
ernment strategy to reduce mortality and improve the 
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health of newborns, children, and mothers in developing 
countries. 
(b) 
COMPONENTS.—The 
comprehensive 
United 
States Government strategy developed pursuant to sub-
section (a) shall include the following: 
(1) An identification of not less than 60 coun-
tries with priority needs for the 5-year period begin-
ning on the date of the enactment of this Act based 
on— 
(A) the number and rate of neonatal 
deaths; 
(B) the number and rate of child deaths; 
and 
(C) the number and rate of maternal 
deaths. 
(2) For each country identified in paragraph 
(1)— 
(A) an assessment of the most common 
causes of newborn, child, and maternal mor-
tality; 
(B) a description of the programmatic 
areas and interventions providing maximum 
health benefits to populations at risk as well as 
maximum reduction in mortality; 
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(C) an assessment of the investments need-
ed in identified programs and interventions to 
achieve the greatest results; 
(D) a description of how United States as-
sistance complements and leverages efforts by 
other donors, as well as builds capacity and 
self-sufficiency among recipient countries; and 
(E) a description of goals and objectives 
for improving maternal, newborn, and child 
health, including, to the extent feasible, objec-
tive and quantifiable indicators. 
(3) An expansion of the Child Survival and 
Health Grants Program of the United States Agency 
for International Development, at a minimum pro-
portionate to any increase in child and maternal 
health assistance, to provide additional support pro-
grams and interventions determined to be efficacious 
and cost-effective in improving health and reducing 
mortality. 
(4) Enhanced coordination among relevant de-
partments and agencies of the United States Gov-
ernment engaged in activities to improve the health 
and well-being of newborns, children, and mothers in 
developing countries. 
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(5) A description of the measured or estimated 
impact on child morbidity and mortality of each 
project or program carried out. 
(c) REPORT.—Not later than 180 days after the date 
of the enactment of this Act, the President shall transmit 
to Congress a report that contains the strategy described 
in this section. 
SEC. 5. INTERAGENCY TASK FORCE ON CHILD SURVIVAL 
AND MATERNAL HEALTH IN DEVELOPING 
COUNTRIES. 
(a) ESTABLISHMENT.—There is established a task 
force to be known as the Interagency Task Force on Child 
Survival and Maternal Health in Developing Countries (in 
this section referred to as the ‘‘Task Force’’). 
(b) DUTIES.— 
(1) IN GENERAL.—The Task Force shall assess, 
monitor, and evaluate the progress and contributions 
of relevant departments and agencies of the Govern-
ment of the United States in achieving the United 
Nations Millennium Development Goals by 2015 for 
reducing the mortality of children under the age of 
5 by two-thirds (Millennium Development Goal 4) 
and reducing maternal mortality by three-quarters 
(Millennium Development Goal 5) in developing 
countries, including by— 
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(A) identifying and evaluating programs 
and interventions that directly or indirectly con-
tribute to the reduction of newborn, child, and 
maternal mortality rates; 
(B) assessing effectiveness of programs, 
interventions, and strategies toward achieving 
the maximum reduction of newborn, child, and 
maternal mortality rates; 
(C) assessing the level of coordination 
among relevant departments and agencies of 
the Government of the United States, the inter-
national community, international organiza-
tions, faith-based organizations, academic insti-
tutions, and the private sector; 
(D) assessing the contributions made by 
United States-funded programs toward achiev-
ing the Millennium Development Goals 4 and 5; 
(E) identifying the bilateral efforts of other 
nations and multilateral efforts toward achiev-
ing the Millennium Development Goals 4 and 5; 
and 
(F) preparing the annual report required 
by subsection (f). 
(2) CONSULTATION.—To the maximum extent 
practicable, the Task Force shall consult with indi-
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viduals with expertise in the matters to be consid-
ered by the Task Force who are not officers or em-
ployees of the Government of the United States, in-
cluding representatives of United States-based non-
governmental organizations (including faith-based 
organizations and private foundations), academic in-
stitutions, private corporations, the United Nations 
Children’s Fund (UNICEF), and the World Bank. 
(c) MEMBERSHIP.— 
(1) NUMBER
AND
APPOINTMENT.—The Task 
Force shall be composed of the following members: 
(A) The Administrator of the United 
States Agency for International Development. 
(B) The Assistant Secretary of State for 
Population, Refugees and Migration. 
(C) The Coordinator of United States Gov-
ernment Activities to Combat HIV/AIDS Glob-
ally. 
(D) The Director of the Office of Global 
Health Affairs of the Department of Health 
and Human Services. 
(E) The Under Secretary for Food, Nutri-
tion and Consumer Services of the Department 
of Agriculture. 
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