H. R. 4693 
One Hundred Seventeenth Congress 
of the 
United States of America 
AT THE SECOND SESSION 
Begun and held at the City of Washington on Monday, 
the third day of January, two thousand and twenty-two 
An Act 
To advance targeted and evidence-based interventions for the prevention and treat-
ment of global malnutrition and to improve the coordination of such programs, 
and for other purposes. 
Be it enacted by the Senate and House of Representatives of 
the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Global Malnutrition Prevention 
and Treatment Act of 2021’’. 
SEC. 2. AUTHORIZATION OF EFFORTS TO PREVENT AND TREAT MAL-
NUTRITION GLOBALLY. 
(a) IN GENERAL.—The Administrator, in coordination with the 
heads of other relevant Federal departments and agencies, is 
authorized and encouraged to support efforts to prevent and treat 
malnutrition globally, including by— 
(1) targeting resources and nutrition interventions to sup-
port the most vulnerable populations susceptible to severe mal-
nutrition, including children under the age of 5 and pregnant 
and lactating women; 
(2) increasing coverage, particularly in priority countries, 
of nutrition interventions that include coordinated deployment 
of prenatal nutrient supplements, breastfeeding support, 
vitamin A supplementation, specialized nutritious food products 
for the treatment of acute malnutrition, and other evidence- 
based interventions, as appropriate; 
(3) increasing the use of context and country-appropriate 
fortification of staples and condiments with essential nutrients; 
(4) advancing evidence-based programs and interventions 
carried out using data-driven approaches, best practices, and 
targeted to country-specific contexts and needs; 
(5) supporting partner governments to develop policies to 
prevent and treat malnutrition; 
(6) leveraging investments to strengthen health systems, 
including to support community health workers to advance 
improved nutrition outcomes; 
(7) improve diets through safe, affordable, nutritious foods 
in the food system; and 
(8) ensuring rigorous monitoring and evaluation of such 
efforts. 
(b) EXTERNAL COORDINATION EFFORTS RELATED TO NUTRITION 
PROGRAMS.—The Administrator, in coordination with the heads of 
other relevant Federal departments and agencies, should coordinate, 
as appropriate, with bilateral and multilateral donors, governments
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of partner countries, United Nations agencies, civil society organiza-
tions, 
nongovernmental 
organizations, 
including 
faith-based 
organizations, and the private sector to prevent and treat malnutri-
tion globally, including by supporting efforts to— 
(1) build the capacity of local and community-based 
organizations and governments of partner countries to ensure 
sustainability of nutrition interventions; 
(2) expand research and innovation to identify and increase 
effective and evidence-based nutrition interventions based on 
country-specific contexts; 
(3) improve coordination and structure of supply chains 
for nutrition interventions; 
(4) expand domestic resource mobilization and domestic 
financing for nutrition interventions; and 
(5) seek to leverage additional resources and encourage 
investment into innovative and multi-stakeholder finance part-
nerships to advance burden sharing in nutrition-related assist-
ance. 
(c) INTERAGENCY EFFORTS.—In carrying out subsections (a) and 
(b), the Administrator, in coordination with the heads of other 
relevant Federal departments and agencies, consistent with the 
Global Nutrition Coordination Plan, shall seek to leverage addi-
tional resources to prevent and treat malnutrition globally, 
including by— 
(1) increasing cooperation among relevant Federal depart-
ments and agencies represented in the Global Nutrition 
Coordination Plan to better leverage grants, technical assist-
ance, debt, equity, loan guaranties, and public-private partner-
ships; and 
(2) utilizing the Administrator’s role as a member of the 
Board of Directors of the United States International Develop-
ment Finance Corporation to consider opportunities within the 
Corporation’s development impact framework that support 
improved nutrition outcomes. 
SEC. 3. SELECTION OF PRIORITY COUNTRIES. 
(a) IN GENERAL.—The Administrator, in coordination with the 
Nutrition Leadership Council, shall select foreign countries as pri-
ority countries for purposes of targeting programs to prevent and 
treat malnutrition globally. 
(b) CRITERIA.—The selection of priority countries under sub-
section (a) shall be based on the following: 
(1) The prevalence of severe malnutrition among children 
under the age of 5 and pregnant and lactating women. 
(2) The presence of high-need, underserved, marginalized, 
vulnerable, or impoverished communities. 
(3) The enabling environment for improved nutrition, 
including presence of national nutrition plans and demonstra-
tion of strong political commitment. 
(4) Any other criteria that the Administrator determines 
to be appropriate. 
(c) UPDATES.—The Administrator shall update the selection 
of priority countries under subsection (a) not later than 5 years 
after the date of the enactment of this Act. 
(d) SENSE
OF CONGRESS.—It is the sense of Congress that 
the Administrator should continue to undertake nutrition interven-
tions in countries not selected as priority countries, particularly
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in contexts in which opportunities are identified to advance multi- 
sectoral development programming and integrate efforts to prevent 
and treat global malnutrition with other priority areas and program 
objectives. 
SEC. 4. NUTRITION LEADERSHIP COUNCIL. 
(a) ESTABLISHMENT.—The Administrator is authorized to estab-
lish in the United States Agency for International Development 
the Nutrition Leadership Council (in this section referred to as 
the ‘‘Council’’), which shall coordinate Agency efforts to prevent 
and treat malnutrition globally. 
(b) DUTIES.—The duties of the Council shall include— 
(1) advancing United States Agency for International 
Development efforts to prevent and treat malnutrition globally; 
(2) ensuring nutrition interventions, particularly in priority 
countries, are carried out in close coordination with other rel-
evant United States Government strategies and policies and 
provisions of law, including— 
(A) the Global Food Security Act of 2016 (22 U.S.C. 
9301 et seq.); 
(B) the Senator Paul Simon Water for the World Act 
of 2014 (22 U.S.C. 2151 note); 
(C) the Global Child Thrive Act of 2020 (subtitle I 
of title XII of division A of Public Law 116–283); and 
(D) the Global Fragility Act of 2019 (22 U.S.C. 9801 
et seq.); and 
(3) ensuring nutrition interventions are coordinated with 
nutrition programs carried out by other relevant Federal 
departments and agencies. 
(c) MEMBERSHIP.—The Council shall include representatives 
of the following bureaus and independent offices of the United 
States Agency for International Development: 
(1) The Bureau for Global Health. 
(2) The Bureau for Resilience and Food Security. 
(3) The Bureau for Humanitarian Assistance. 
(4) Any other relevant bureau or independent office that 
the Administrator determines to be appropriate. 
SEC. 5. IMPLEMENTATION PLAN. 
(a) IN GENERAL.—Not later than 260 days after the date of 
the enactment of this Act, the Administrator, in coordination with 
the heads of other relevant Federal departments and agencies, 
shall develop and submit to the appropriate congressional commit-
tees an implementation plan for programs to prevent and treat 
malnutrition globally described in section 2. 
(b) MATTERS TO BE INCLUDED.—The implementation plan 
required by subsection (a) shall include the following: 
(1) A description of specific and measurable goals, objec-
tives, and performance metrics with respect to such programs, 
including clear benchmarks and intended timelines for 
achieving such goals and objectives. 
(2) A description of monitoring and evaluation plans with 
respect to such programs, as appropriate.
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(3) In priority countries, a description of efforts to ensure 
that nutrition is adequately addressed in the Country Develop-
ment Cooperation Strategy to the extent practicable and iden-
tify opportunities to expand efforts to prevent and treat mal-
nutrition, including through leveraging existing health and 
development programs and other ongoing activities. 
(c) CONSULTATION.—The implementation plan required by sub-
section (a) shall be developed in consultation with, as appropriate 
and to the extent possible, representatives of nongovernmental 
organizations, including faith-based organizations, civil society 
organizations, multilateral organizations and donors, relevant pri-
vate, academic, and philanthropic entities, and the appropriate 
congressional committees. 
SEC. 6. REPORT. 
(a) IN GENERAL.—Not later than one year after the date of 
the enactment of this Act, and annually thereafter for 5 years, 
the Administrator shall submit to the appropriate congressional 
committees a report that describes progress made towards pre-
venting and treating malnutrition globally. 
(b) MATTERS TO BE INCLUDED.—The report required by sub-
section (a) shall include the following: 
(1) A summary of progress made towards achieving the 
specific and measurable goals, objectives, and performance 
metrics towards ending global malnutrition. 
(2) In priority countries— 
(A) a detailed summary of nutrition programs and 
activities in the previous fiscal year, including a breakdown 
of the countries to which nutrition resources have been 
allocated and an estimated number of people reached 
through nutrition interventions; and 
(B) an description of the coordination of nutrition pro-
grams with other health and development programs and 
priorities. 
(3) A summary of efforts to expand research and innovation 
to development and scale up new tools to prevent and treat 
malnutrition globally. 
(4) An assessment of the collaboration and coordination 
of nutrition efforts of the United States Agency for International 
Development with United Nations agencies, the World Bank, 
other donor governments, host country governments, civil 
society, and the private sector, as appropriate. 
(5) A description of other donor country and host country 
financial commitments and efforts to prevent and treat mal-
nutrition. 
(6) An identification of constraints on implementation of 
programs and activities and lessons learned from programs 
and activities from the previous fiscal years. 
(c) INCLUSION
IN OTHER REPORTS.—The Administrator may 
include the report required by subsection (a) as a component of 
other congressionally mandated reports provided to appropriate 
congressional committees, as appropriate. 
SEC. 7. COMPLIANCE WITH THE FOREIGN AID TRANSPARENCY AND 
ACCOUNTABILITY ACT OF 2016. 
Section 2(3) of the Foreign Aid Transparency and Accountability 
Act of 2016 (22 U.S.C. 2394c note) is amended— 
(1) in subparagraph (C), by striking ‘‘and’’ at the end;
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(2) in subparagraph (D), by striking the period at the 
end and inserting ‘‘; and’’; and 
(3) by adding at the end the following: 
‘‘(E) the Global Malnutrition Prevention and Treatment 
Act of 2021.’’. 
SEC. 8. DEFINITIONS. 
In this Act: 
(1) ADMINISTRATOR.—The term ‘‘Administrator’’ means the 
Administrator of the United States Agency for International 
Development. 
(2) APPROPRIATE CONGRESSIONAL COMMITTEES.—The term 
‘‘appropriate congressional committees’’ means— 
(A) the Committee on Foreign Affairs and the Com-
mittee on Appropriations of the House of Representatives; 
and 
(B) the Committee on Foreign Relations and the Com-
mittee on Appropriations of the Senate. 
(3) NUTRITION LEADERSHIP COUNCIL.—The term ‘‘Nutrition 
Leadership Council’’ means Nutrition Leadership Council estab-
lished by section 4. 
(4) PRIORITY COUNTRY.—The term ‘‘priority country’’ means 
a foreign country selected under section 3 for purposes of tar-
geting programs to prevent and treat malnutrition globally. 
SEC. 9. SUNSET. 
The requirements of this Act and the amendments made by 
this Act shall terminate on the date that is 7 years after the 
date of the enactment of this Act. 
Speaker of the House of Representatives. 
Vice President of the United States and
President of the Senate.