I
106TH CONGRESS
1ST SESSION
H. R. 2028
To authorize appropriations for fiscal year 2000 for infant and child health
programs under chapters 1 and 10 of part I of the Foreign Assistance
Act of 1961, and for other purposes.
IN THE HOUSE OF REPRESENTATIVES
JUNE 7, 1999
Mr. PITTS (for himself, Mr. SMITH of New Jersey, Mr. MCINTOSH, and Mr.
WOLF) introduced the following bill; which was referred to the Committee
on International Relations
A BILL
To authorize appropriations for fiscal year 2000 for infant
and child health programs under chapters 1 and 10
of part I of the Foreign Assistance Act of 1961, 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. FINDINGS.
The Congress finds the following:
(1) Every year, an estimated 12,000,000 chil-
dren under the age of 5 years die, mostly of easily
preventable causes, and about 160,000,000 children
are severely or moderately malnourished throughout
the world.
(2) Despite significant progress made in child
survival efforts, 32,000 children continue to die
every day, largely from preventable causes.
(3) Of the 12,000,000 children under 5 who die
each year from preventable causes, 6,000,000 die di-
rectly or indirectly from malnutrition.
(4) The under-5 mortality rate (171 per 1,000
live births) in the least developed countries is nearly
25 times that of the industrialized nations.
(5) Diarrheal dehydration remains one of the
world’s most widespread child killers, claiming over
2,000,000 children under the age of 5 each year in
developing countries, and for just 7 cents per dose
per child, oral rehydration therapy and continued
feeding (ORT), a simple, cost-effective treatment
given at home, could prevent as many as 90 percent
of all child deaths from diarrheal diseases.
(6) Although 80 percent of children are now
being vaccinated against the 6 major killer diseases
(measles, tetanus, whooping cough, tuberculosis,
polio, and diphtheria), 2,000,000 children are still
dying 
from 
these 
diseases 
each 
year. 
Only
$30,000,000 ($15 per child) would provide vaccines,
syringes, needles, cold chain equipment, and health
workers’ training and salaries needed to immunize
2,000,000 children against these 6 major childhood
diseases.
(7) Malaria kills more than 1,000,000 children
under the age of 5 each year, or 1 child every 30
seconds, but for less than $15,000,000, all of these
children could be provided bed nets to help protect
them from this deadly disease.
(8) An estimated 2,900,000,000 people lack ac-
cess to adequate sanitation, up from 2,600,000,000
in 1990, and without a stronger commitment to
sanitation, it will be difficult to reduce the incidence
of diarrhea, a leading child killer, and other diseases
that flourish in unsanitary conditions. For only
$5.50, 1 plastic latrine pan and outlet pipe could
provide safe sanitation for 1 family, and for $150,
a handpump, pipe, and accessories for equipping a
shallow well could benefit up to 250 people.
(9) 2,200,000 children under the age of 5 die
each year in developing countries of acute res-
piratory infections (ARI). Appropriate treatment of
ARI, including early diagnosis and the proper use of
antibiotics, could avert 30 to 60 percent of ARI-re-
lated child deaths.
(10) About 100,000,000 children under the age
of 5 suffer from vitamin A deficiency, which impairs
children’s ability to resist illnesses and contributes
to nearly 25 percent of under-5 deaths in developing
countries, but 6 cents can buy 3 vitamin A capsules
to protect a child against blindness and other health
risks from vitamin A deficiency for 1 year, or
$6,000,000 could protect 100,000,000 children an-
nually against such blindness and other health risks.
(11) Because a major global immunization cam-
paign is nearing the goal of eradicating polio, a 10-
year effort to eradicate polio through childhood vac-
cination 
and 
surveillance 
would 
cost 
only
$100,000,000 per year.
(12) Up to 1,500,000 children annually could
be saved by increased breast-feeding because breast-
fed infants are up to 25 times less likely to die of
diarrheal disease, and 4 times less likely to die of
acute respiratory infections.
(13) Nevertheless, estimates that each year
more than 540,000 infants are infected by Mother
To Child Transmission (MTCT) of the HIV virus in
Africa alone indicate the urgent need for safe and
practical alternatives to breast-feeding by nursing
mothers who are HIV-positive to help prevent the
transmission of the virus to their babies.
SEC. 2. AUTHORIZATION OF APPROPRIATIONS FOR CHILD
SURVIVAL PROGRAMS.
(a) AUTHORIZATION OF APPROPRIATIONS.—
(1) IN GENERAL.—There is authorized to be
appropriated for fiscal year 2000 $345,000,000 for
infant and child health programs under chapters 1
and 10 of part I of the Foreign Assistance Act of
1961 (22 U.S.C. 2151 and 2293 et seq.) that have
a direct, measurable, and high impact on reducing
the incidence of illness and death among children.
(2) 
ADDITIONAL
REQUIREMENT.—Of 
the
amount appropriated pursuant to the authorization
of appropriations under paragraph (1), not less than
25 percent of such amount shall be allocated for pro-
grams of United States-based, citizen-supported, pri-
vate voluntary organizations that implement commu-
nity-based programs.
(b) LIMITATION ON POPULATION PLANNING ASSIST-
ANCE.—Notwithstanding any other provision of law, not
more than $285,000,000 of the amounts appropriated in
title II of the Foreign Operations, Export Financing, and
Related Programs Appropriations Act, 2000, to carry out
any of the provisions of law described in such title may
obligated or expended for population planning activities or
other population assistance, including all programs and
activities designed to control fertility or to reduce or delay
childbirths or pregnancies.
Æ