I 
116TH CONGRESS 
1ST SESSION H. R. 4864 
To develop and implement policies to advance early childhood development, 
to provide assistance for orphans and other vulnerable children in devel-
oping countries, and for other purposes. 
IN THE HOUSE OF REPRESENTATIVES 
OCTOBER 28, 2019 
Mr. CASTRO of Texas (for himself, Mr. FITZPATRICK, Mrs. WATSON COLE-
MAN, Mr. CISNEROS, and Ms. MOORE) introduced the following bill; 
which was referred to the Committee on Foreign Affairs 
A BILL 
To develop and implement policies to advance early childhood 
development, to provide assistance for orphans and other 
vulnerable children 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 ‘‘Global Child Thrive 
Act of 2019’’. 
SEC. 2. FINDINGS. 
Congress finds the following: 
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(1) According to a 2019 report from the United 
Nations Inter-Agency Group for Child Mortality Es-
timation entitled ‘‘Levels & Trends in Child Mor-
tality’’, the total number of deaths among children 
younger than 15 years of age dropped by 56 percent 
between 1990 and 2018, from approximately 
14,200,000 to approximately 6,200,000. 
(2) According to a 2016 article published in 
The Lancet entitled ‘‘Early childhood development: 
the foundation of sustainable development’’— 
(A) an estimated 250,000,000 children in 
low-income and middle-income countries suffer 
suboptimal development due to poverty and 
stunting alone; and 
(B) children who do not meet develop-
mental milestones are expected to lose about 25 
percent of their average yearly income once 
they become adults. 
(3) According to a report from the United Na-
tions Children’s Fund (UNICEF), entitled ‘‘The 
State of the World’s Children 2016: A fair chance 
for every child’’, nearly 250,000,000 of the world’s 
650,000,000 primary school age children do not 
master basic literacy and numeracy. 
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(4) According to a 2018 report from the World 
Health Organization entitled ‘‘Nurturing Care for 
early childhood development’’— 
(A) the environment in which a child grows 
has a profound impact on future learning, be-
havior, and health; and 
(B) a country’s economic diversity and 
growth could be improved by investment in 
early childhood development. 
(5) According to a 2017 UNICEF report enti-
tled ‘‘UNICEF’s Programme Guidance for Early 
Childhood Development’’, nurturing care, which is 
key to early childhood development, consists of a 
core set of interrelated components, including— 
(A) behaviors, attitudes, and knowledge 
about caregiving, including health, hygiene care, 
and feeding; 
(B) stimulation, such as talking, singing, 
and playing; 
(C) responsiveness, such as early bonding, 
secure attachment, trust, and sensitive commu-
nication; and 
(D) safety, including routines, protection 
from violence, abuse, neglect, harm, and envi-
ronmental pollution. 
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(6) According to a 2016 report published in 
The Lancet entitled ‘‘Advancing Early Childhood 
Development: From Science to Scale’’— 
(A) nurturing care from parents, relatives, 
and other caregivers and services are formative 
experiences for young children; 
(B) programs promoting nurturing care 
can improve early childhood development out-
comes; and 
(C) children who do not receive nurturing 
care display negative development outcomes, 
such as greater sensitivity to the effects of 
stress or behavioral problems, especially chil-
dren who do not receive nurturing care before 
their second birthday. 
(7) According to the ‘‘United States Govern-
ment Action Plan on Children in Adversity, A 
Framework for International Assistance: 2012– 
2017’’, children who live without protective family 
care, in abusive households, on the streets, or in in-
stitutions, or who are trafficked, are participating in 
armed groups, or are being exploited for their labor 
are more likely to be exposed to violence, exploi-
tation, abuse, and neglect. 
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(8) According to a 2017 UNICEF report enti-
tled ‘‘Early Moments Matter for every child’’, vio-
lence, abuse, neglect, and traumatic experiences 
produce toxic stress that limits neural connectivity 
in developing brains. 
(9) According to a 2014 working paper from 
the National Scientific Council on the Developing 
Child at Harvard University entitled ‘‘Excessive 
Stress Disrupts the Architecture of the Developing 
Brain’’— 
(A) situations that produce toxic stress in-
crease the production of cortisol in a child’s 
brain, which disrupts its healthy development; 
and 
(B) chronic stress can potentially affect 
the expression of genes that regulate the stress 
response across the life course. 
(10) According to a 2018 article in the North 
Carolina Medical Journal entitled ‘‘Adverse Child-
hood Experiences (ACEs): An Important Element of 
a Comprehensive Approach to the Opioid Crisis’’, 
adverse childhood experiences (ACEs) are traumatic 
or stressful experiences, including emotional, phys-
ical, or sexual abuse, domestic violence, household 
substance abuse, household mental illness, parental 
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separation or divorce, and the incarceration of a 
household family member. 
(11) According to a 2016 report in Develop-
ment and Psychopathology entitled ‘‘Childhood Ad-
versity and Epigenetic Regulation of Glucocorticoid 
Signaling Genes: Associations in Children and 
Adults’’— 
(A) children and adults are at risk of de-
veloping psychiatric disorders and other medical 
conditions if they have had an adverse child-
hood experience (ACE); and 
(B) adults who have had numerous ACEs 
die nearly 20 years earlier, on average, than 
adults who have not had numerous ACEs. 
SEC. 3. SENSE OF CONGRESS. 
It is the sense of Congress that— 
(1) it is time to build on the reduction in pre-
ventable child deaths worldwide achieved by focusing 
new efforts and attention on— 
(A) saving children’s lives; and 
(B) supporting the healthy development of 
children’s brains; 
(2) methods of delivering parent training and 
education on nurturing care, such as the Center for 
Disease Control and Prevention’s Maternal, Infant, 
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