(1) The United Nations Children’s Fund
(UNICEF) estimates that 35,000 children die each
day from malnutrition and preventable disease.
(2) The World Summit for Children held in
1990, the largest gathering of heads of state and
heads of government up until that time, united the
world in a commitment to protect the lives of chil-
dren, diminish their suffering, and enhance their
futures.
(3) This commitment is reflected in specific
goals that require international cooperation and the
commitment of all nations, goals which were incor-
porated in Agenda 21 at the 1992 Earth Summit
and which were also endorsed in the World Declara-
tion on Nutrition adopted at the 1992 International
Conference on Nutrition. The World Summit for
Children goals include cutting child deaths by at
least 1⁄3, halving maternal mortality and child mal-
nutrition, providing all children access to a basic
education, and providing all families access to clean
water, safe sanitation, and family planning services.
(4) The United Nations Children’s Fund esti-
mates that these goals could be implemented by the
year 2000 with a global commitment of just
$25,000,000,000 annually, to be achieved through
reallocation of resources to increase the proportion
of resources going to meet basic human needs, with
2⁄3 of those resources coming from the developing
nations themselves and 1⁄3 from the industrialized
nations.
(5) The United Nations Children’s Fund esti-
mates that currently only 10 percent of developing
country budgets and less than 10 percent of all
international assistance for development is devoted
to meeting basic human needs.
(6) If that proportion were doubled to just 20
percent, through reallocation of current resources
and without requiring additional resources, this
would provide the additional $25,000,000,000 the
United Nations Children’s Fund estimates is re-
quired annually to achieve by the year 2000 the
goals of the World Summit for Children.
(7) The United States Government participated
in the World Summit for Children and signed the
Declaration and Plan of Action adopted at that
Summit.
(8) Participants in the Summit committed
themselves and their governments—
(A) to prepare, before the end of 1991, na-
tional programs of action to help implement the
goals and objectives of the Summit, and
(B) to take steps to ensure that child sur-
vival, protection, and development programs will
have a priority in the allocation of resources.
(9) The United States Government should im-
plement a plan of action to fulfill its commitment to
children, both at home and abroad.
(b) PURPOSES.—The purposes of this Act are—
(1) to help fulfill the commitment of the United
States Government to children; and
(2) to provide the necessary authorities to im-
plement the United States plan of action.
SEC. 3. SPECIAL SUPPLEMENTAL FOOD PROGRAM FOR
WOMEN, INFANTS, AND CHILDREN (WIC).
(a) FINDINGS.—The Congress finds the following:
(1) In 1990, the Surgeon General and the Unit-
ed States Public Health Service announced Healthy
People 2000 goals for America’s children. These
goals include reducing the United States infant mor-
tality rate and the incidence of low birthweight by
1⁄3 by the year 2000, as well as the initiation of
breastfeeding by 75 percent of mothers and the con-
tinuation of breastfeeding at 6 months postpartum
by 50 percent of mothers.
(2) The special supplemental food program for
women, infants, and children authorized under sec-
tion 17 of the Child Nutrition Act of 1966 (in this
section referred to as the ‘‘WIC Program’’) is in-
tended to benefit low-income women at risk of deliv-
ering low birthweight babies, low-income infants and
children at risk of malnutrition, and low-income
nursing mothers.
(3) It has been demonstrated that participation
in the WIC Program reduces, in a cost-effective
manner, the number of premature births and the
percentage of infants born at low birthweight, a
major cause of infant mortality and developmental
disabilities, and decreases the prevalence of iron de-
ficiency anemia in children, and improves children’s
cognitive development.
(4) Increasing the rate of breastfeeding among
mothers participating in the WIC Program would re-
sult in greater improvements in the health of infants
and mothers, further reductions in infant mortality,
and decreases in health care costs and infant for-
mula expenditures.
(5) Particular attention needs to be given to
promoting breastfeeding within the WIC Program
through activities which include support of peer
counselors working through the WIC Program, utili-
zation of lactation consultants in WIC Program clin-
ics and in hospitals, and training of health profes-
sionals in lactation management and development of
education materials.
(6) The WIC Program currently serves 58 per-
cent of the eligible population and actions need to be
taken to move toward service to the entire eligible
population.
(b) FULL PARTICIPATION IN THE WIC PROGRAM.—
It is the sense of the Congress that—
(1) the United States Government should make
a commitment to achieving full participation in the
WIC Program by fiscal year 1996; and
(2) in order to reach the goal of full participa-
tion, not less than $3,287,000,000 for fiscal year
1994 and not less than $3,564,000,000 for the fiscal
year 1995 should be appropriated to carry out the
WIC Program.
SEC. 4. PROGRAMS UNDER THE HEAD START ACT.
(a) FINDINGS.—The Congress finds the following:
(1) In 1990, the President and the Governors
of the 50 States met at the Education Summit and
set United States education goals for the year 2000,
including the goal that all children start school ready
to learn.
(2) Since their inception in 1964, programs
under the Head Start Act have established an im-
pressive record in providing preschool-age children
from low-income families with comprehensive serv-
ices to address educational, social, nutritional, and
health needs.
(3) Head Start programs serve only about 1⁄3 of
eligible children between 3 and 5 years of age.
(b) FULL FUNDING FOR THE HEAD START ACT.—
It is the sense of the Congress that—
(1) the Federal Government should make a
commitment to achieving full participation of all eli-
gible 3- and 4-year-old children in Head Start pro-
grams by the fiscal year 1999, and
(2) in order to reach the goal of such full par-
ticipation, not less than $4,150,000,000 for the fis-
cal year 1994, and not less than $4,970,000,000 for
the fiscal year 1995, should be appropriated to carry
out the Head Start Act.
SEC. 5. INTERNATIONAL INFANT AND CHILD MORTALITY.
(a) FINDINGS.—The Congress finds the following:
(1) During the last decade the international
campaign to save the lives of children has resulted
in dramatic increases in the adoption of low-cost
measures to save children’s lives, such as immuniza-
tions and oral rehydration therapy.
(2) In September 1991, the United Nations
Children’s Fund and the World Health Organization
were able to report that the goal of 80 percent child-
hood immunization had been achieved, saving over
12,000,000 young lives during the last decade and
continuing to save over 3,000,000 children’s lives
each year.
(3) The Plan of Action adopted by the World
Summit for Children calls for the reduction of
under-5 mortality rates by at least 1⁄3 by the year
2000.
(4) Such progress is possible by consolidating
gains already made, and by pursuing new goals and
effective programs in such areas as measles,
neonatal tetanus, poliomyelitis, and acute respiratory
infections.
(5) Efforts should focus on the delivery of com-
munity-based primary health care and health edu-
cation services which directly benefit the poorest of
the poor, with an emphasis toward small scale
projects rather than large scale infrastructure
projects. Such assistance should be provided through
private and voluntary organizations and inter-
national organizations whenever possible.
(6) Both the United Nations Children’s Fund
and the United States Agency for International De-
velopment have provided strong leadership as well as
financial and technical support for these goals.
(b) CONTRIBUTIONS TO UNICEF.—To carry out sec-
tion 301 of the Foreign Assistance Act of 1961 (22 U.S.C.
2221; relating to voluntary contributions to international
organizations and programs), there are authorized to be
appropriated $115,000,000 for fiscal year 1994 and
$130,000,000 for fiscal year 1995 for contributions to the
United Nations Children’s Fund for activities to promote
child health and other assistance programs on behalf of
children.
(c) CHILD SURVIVAL ACTIVITIES.—Section 104(c)(2)
of the Foreign Assistance Act of 1961 (22 U.S.C.
2151b(c)(2); relating to the Child Survival Fund) is
amended—
(1) in subparagraph (B), by striking out
‘‘$25,000,000 for fiscal year 1986 and $75,000,000
for fiscal year 1987’’ and inserting in lieu thereof
‘‘$150,000,000 
for 
fiscal 
year 
1994 
and
$210,000,000 for fiscal year 1995’’; and
(2) by inserting after subparagraph (C) the
following:
‘‘(D) Of the aggregate of the amounts made available
to carry out subparagraph (B) of this paragraph, sections
103(a) and section 106 of this chapter, chapter 10 of this
part, and chapter 4 of part II and for the Multilateral
Assistance Initiative for the Philippines, not less than
$405,000,000 for fiscal year 1994 and not less than
$490,000,000 for fiscal year 1995 shall be available only
for activities described in subparagraph (A), with a par-
ticular emphasis on delivery of community-based primary
health care and health education services which benefit the
poorest of the poor. Such assistance shall be provided
through private and voluntary organizations and inter-
national organizations whenever possible.’’.
SEC. 6. GLOBAL MALNUTRITION.
(a) FINDINGS.—The Congress finds the following:
(1) Malnutrition (including protein-calorie mal-
nutrition and micronutrient deficiencies), which is
currently the underlying cause of death in the vast
majority of childhood diseases, is preventable at low
cost.
(2) Vitamin A deficiency remains a scourge of
children in developing countries. If access to vitamin
A is not increased, an estimated 2,000,000 children
face blindness in the 1990s and tens of millions
more face increased risk of infection and death. Vi-
tamin A intake has been associated with significant
reductions in infant mortality rates.
(3) One billion people are at risk of iodine defi-
ciency disease, with the very young being most vul-
nerable. Iodine deficiency is a major cause of mental
retardation worldwide.
(4) Two billion people suffer from some degree
of iron deficiency anemia, particularly women of
childbearing age and young children.
(5) The Plan of Action adopted at the World
Summit for Children calls for halving severe and
moderate malnutrition among children under 5 years
of age by the year 2000, for the virtual elimination
of vitamin A deficiency and iodine deficiency dis-
orders by the year 2000, and for the reduction of
iron deficiency anemia among women of childbearing
age by 1⁄3 of the 1990 levels.
(6) The Congress has already undertaken sub-
stantial action to address this problem in the Food,
Agriculture, Conservation, and Trade Act of 1990,
which established food security for the poorest and
the prevention of malnutrition as priorities in food
assistance programs administered by the Agency for
International Development under the Agriculture
Trade Development and Assistance Act of 1954.
(7) Child survival activities are also key to re-
ducing child malnutrition and must be pursued in
conjunction with efforts to ensure food security.
(8) Section 411 of the Agricultural Trade De-
velopment and Assistance Act of 1954 (7 U.S.C.
1736e), as amended by the Food, Agriculture, Con-
servation, and Trade Act of 1990, authorizes the
forgiveness of Public Law 480 debt owed by least
developed countries that are pursuing national eco-
nomic policy reforms that would promote long-term
economic development, but the exercise of that au-
thority requires further action by the Congress in an
appropriations Act.
(b) PUBLIC LAW 480 DEBT AUTHORITY.—It is the
sense of the Congress that authority, in such amounts as
may be required, should be granted to the President in
an appropriations Act to exercise the debt authority with
respect to least developed countries that is provided in sec-
tion 411 of the Agricultural Trade Development and As-
sistance Act of 1954.
(c) VITAMIN A DEFICIENCY PROGRAM.—Section 103
of the Foreign Assistance Act of 1961 (22 U.S.C. 2151a;
relating to development assistance for agriculture, rural
development, and nutrition) is amended by adding at the
end the following new subsection:
‘‘(h) VITAMIN A DEFICIENCY PROGRAM.—(1) The
Congress finds that—
‘‘(A) vitamin A deficiency is a major cause of
childhood mortality;
‘‘(B) vitamin A intervention programs are inex-
pensive, practical to administer, and cost-effective in
terms of human productivity; and
‘‘(C) the Agency for International Development
is already implementing a Vitamin A Deficiency
Program.
‘‘(2) Of the amounts made available to carry out this
section, not less than $28,000,000 for fiscal year 1994
and not less than $42,000,000 for fiscal year 1995 shall
be available only for Vitamin A supplementation and for-
tification through the Vitamin A Deficiency Program.’’.
(d) OTHER MICRONUTRIENT DEFICIENCIES.—In ad-
dition to amounts otherwise available for such programs,
there are authorized to be appropriated $22,000,000 for
fiscal year 1994 and $33,000,000 for fiscal year 1995 for
iodine and iron fortification programs, and for iron
supplementation programs for pregnant women, under
part I of the Foreign Assistance Act of 1961.
SEC. 7. MATERNAL AND CHILD MORTALITY RESULTING
FROM AIDS.
(a) FINDINGS.—The Congress finds the following:
(1) As of 1992, nearly 5,000,000 women of
childbearing age and over 1,000,000 children were
infected with the human immunodeficiency virus
(HIV), the virus that causes the acquired immune
deficiency syndrome (AIDS). The vast majority of
these women and children live in developing coun-
tries.
(2) The maternal and child mortality rate in
many developing countries will increase dramatically,
as will the number of orphans infected with the
human immunodeficiency virus, until prevention and
control efforts are successful.
(3) The most effective efforts to respond to the
human immunodeficiency virus and acquired im-
mune deficiency syndrome are based at the commu-
nity level and involve nongovernmental organizations
as well as government agencies.
(4) The Agency for International Development
should expand its assistance to developing countries
for community-based prevention, care, and control
programs and activities relating to the human
immunodeficiency virus and acquired immune defi-
ciency syndrome, and should participate in coordi-
nated efforts with other donors.
(5) Coordination of efforts of bilateral, multilat-
eral, and nongovernmental agencies and organiza-
tions is essential.
(b) INTERNATIONAL AIDS PREVENTION AND CON-
TROL FUND.—Section 104(c) of the Foreign Assistance
Act of 1961 (22 U.S.C. 2151b(c); relating to development
assistance for health related activities) is amended by add-
ing at the end the following new paragraph:
‘‘(4)(A) In carrying out this subsection, the President
shall promote, encourage, and undertake community-based
prevention, care, and control programs and activities relat-
ing to the human immunodeficiency virus (HIV) and ac-
quired immune deficiency syndrome (AIDS) in developing
countries, including research as to the effectiveness of
such programs and activities.
‘‘(B) There are authorized to be appropriated
$100,000,000 for fiscal year 1994 and $120,000,000 for
fiscal year 1995 for use in carrying out this paragraph,
which shall be in addition to amounts made available
under subsection (g) or otherwise available for such pur-
pose. Amounts appropriated under this subparagraph are
authorized to remain available until expended.
‘‘(C) Appropriations pursuant to subparagraph (B)
may be referred to as the ‘International AIDS Prevention
and Control Fund’.’’.
SEC. 8. INTERNATIONAL BASIC EDUCATION.
(a) FINDINGS.—The Congress finds the following:
(1) Primary education, early childhood develop-
ment activities, and programs to achieve literacy, are
essential for increasing the productive capacity of
people and their ability to earn income.
(2) At least 130,000,000 children of primary
school age, 2⁄3 of them girls, are not enrolled in
school. Thirty-four countries have literacy rates of
40 percent or less.
(3) The share of government resources devoted
to education in more than half of the 40 poorest
countries in the world has decreased since 1980.
(4) The Plan of Action adopted by the World
Summit for Children calls for basic education for all
children and for completion of primary education by
at least 80 percent of all children.
(5) United States assistance for basic education
in developing countries has accounted for less than
2 percent of all United States foreign assistance in
recent years.
(b) INTERNATIONAL BASIC EDUCATION.—Section
105 of the Foreign Assistance Act of 1961 (22 U.S.C.
2151c; relating to development assistance for education
and human resource development) is amended by adding
at the end the following new subsection:
‘‘(c) BASIC EDUCATION.—Of the aggregate of the
amounts made available to carry out this section, chapter
10 of this part, and chapter 4 of part II and for the Multi-
lateral Assistance Initiative for the Philippines, not less
than $225,000,000 for fiscal year 1994 and not less than
$380,000,000 for fiscal year 1995 shall be available only
for programs in support of basic education, including early
childhood education, primary education, teacher training,
and other necessary activities in support of early childhood
and primary education, and literacy training for adults.’’.
SEC. 9. INTERNATIONAL FAMILY PLANNING AND CHILD
SPACING.
(a) FINDINGS.—The Congress finds the following:
(1) Universal access to voluntary family plan-
ning could save the lives of several million children
each year and could significantly improve the health
of children throughout the developing world by re-
ducing prematurity and low birthweight and allowing
longer breastfeeding.
(2) The risk of maternal death or illness in the
developing world is highest for women who bear chil-
dren when they are under the age of 18 or over the
age of 35, for pregnancies spaced less than 2 years
apart, and for women who already have 4 or more
children. Universal access to voluntary family plan-
ning could prevent up to 1⁄3 of the 500,000 maternal
deaths annually.
(3) The inability of couples to plan births de-
creases the quality of women’s lives and undermines
their opportunities for education, for earning in-
come, for improving the care of children, and for
community activities and personal development.
(4) Rapid world population growth, combined
with unsustainable patterns of natural resource con-
sumption, has become an urgent economic, social,
and environmental problem.
(5) Demographic and health surveys indicate
that if all women in the developing world who do not
wish to become pregnant were empowered to plan
the size of their families, then the rate of population
growth would fall by approximately 30 percent.
(6) The Plan of Action adopted at the World
Summit for Children calls for voluntary family plan-
ning services and education to be made available to
all couples to empower them to prevent unwanted
pregnancies and births which are ‘‘too many and too
close’’ and to women who are ‘‘too young or too
old’’.
(b) AUTHORIZATIONS OF APPROPRIATIONS.—In ad-
dition to any other amounts made available for such pur-
poses, there are authorized to be appropriated to the
President for United States population assistance pro-
grams and activities under part I of the Foreign Assist-
ance Act of 1961 $725,000,000 for fiscal year 1994 and
$800,000,000 for fiscal year 1995.
SEC. 10. REFUGEES.
(a) FINDINGS.—The Congress finds the following:
(1) The number of refugees worldwide has
grown from 10,000,000 in 1985 to 17,400,000 in
1993. In addition, there are estimated to be more
than 24,000,000 internally displaced persons. More
than half of these refugees and internally displaced
persons are children.
(2) The dramatic growth in the number of refu-
gees and displaced persons has resulted in serious
reductions in legal assistance and protection, health,
nutrition, and basic education services available to
them.
(3) Refugee children are particularly vulnerable
in first asylum camps from Africa to Southeast Asia
where they languish without the comfort of a parent
or adult guardian.
(b) FUNDING
FOR
REFUGEE
ASSISTANCE
PRO-
GRAMS.—It is the sense of the Congress that—
(1) not less than $760,000,000 for each of fis-
cal years 1994 and 1995 should be appropriated for
the ‘‘Migration and Refugee Assistance’’ account, of
which not less than $420,000,000 for each fiscal
year should be available only for programs of refu-
gee assistance overseas (in addition to the amounts
available for programs for refugees from the former
Soviet Union, Eastern Europe, and elsewhere who
resettle in Israel); and
(2) not less than $100,000,000 for each of fis-
cal years 1994 and 1995 should be appropriated for
the ‘‘United States Emergency Refugee and Migra-
tion Assistance Fund’’ account.
SEC. 11. THE WORLD BANK.
(a) INSTRUCTIONS
TO U.S. EXECUTIVE DIREC-
TORS.—The Secretary of the Treasury shall instruct the
United States Executive Director of the World Bank to
promote vigorously that the World Bank take action—
(1) to ensure that poverty reduction and sup-
port of basic human needs become a higher priority
within the Bank, specifically through increasing the
proportion of International Development Association
investments that fall within the program of targeted
interventions against poverty to 40 percent of all
International Development Association investments
by fiscal year 1994 and to at least 50 percent of all
International Development Association investments
by fiscal year 1995;
(2) within the field of water and sanitation, to
ensure that the majority of water and sanitation
projects fall within the program of targeted interven-
tions against poverty and to increase significantly
the proportion of World Bank lending for projects
utilizing basic low-cost technologies to provide water
and sanitation to underserved poor populations in
deprived rural and periurban areas; and
(3) to increase the proportion of total World
Bank lending which supports primary health care
and basic education, with a minimum of 5 percent
of total lending devoted to each area.
(b) DEFINITION.—As used in this section the term
‘‘World Bank’’ means the International Bank for Recon-
struction and Development and the International Develop-
ment Association.
SEC. 12. EFFORTS BY OTHER COUNTRIES.
The President shall call upon the governments of
other countries to provide their share of the resources re-
quired to achieve the World Summit for Children goals
by the year 2000, specifically through giving highest prior-
ity to increasing the proportion of public expenditures and
foreign assistance devoted to priority human needs areas
outlined in the Declaration and Plan of Action of the
World Summit for Children.
SEC. 13. ANNUAL REPORT.
(a) REQUIREMENT FOR REPORT.—In order that the
Congress and the American people may be fully informed
of efforts undertaken by the United States Government
to fulfill agreements signed by the United States at the
World Summit for Children, the President shall report an-
nually to the Congress on United States contributions to
the achievement of the goals of the World Summit for
Children. Each such report should include—
(1) a discussion of efforts by the United States
to achieve those goals both within the United States
and in other countries; and
(2) a comparative analysis of current and past
funding levels and planned funding levels for the
next 2 fiscal years.
(b) SUBMISSION DATE.—The reports required by this
section shall be submitted to the Congress no later than
February 1 of each year.
Æ
HR 2501 IH——2