[Congressional Bills 109th Congress]
[From the U.S. Government Publishing Office]
[H.R. 4188 Introduced in House (IH)]







109th CONGRESS
  1st Session
                                H. R. 4188

To amend the Foreign Assistance Act of 1961 to improve voluntary family 
   planning programs in developing countries, and for other purposes.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                            November 1, 2005

Ms. McCollum of Minnesota (for herself, Mr. Ramstad, Mr. Oberstar, and 
  Mr. Shays) introduced the following bill; which was referred to the 
                  Committee on International Relations

_______________________________________________________________________

                                 A BILL


 
To amend the Foreign Assistance Act of 1961 to improve voluntary family 
   planning programs in developing countries, 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 ``Focus on Family Health Worldwide Act 
of 2005''.

SEC. 2. FINDINGS.

    Congress finds the following:
            (1) Since 1965, the people and Government of the United 
        States have supported international voluntary family planning 
        programs, increasing the use of modern contraceptives in the 
        developing world from fewer than 10 percent of couples in 1965 
        to more than 40 percent of couples today.
            (2) United States funding for international family planning 
        is today providing services to 20 million couples in the 
        world's poorest countries, contributing to family well-being by 
        improving maternal health, reducing maternal and infant deaths, 
        preventing abortions, and improving the lives of millions of 
        families.
            (3) The United States spends on average three cents per 
        American per week for international family planning programs.
            (4) In the developing world, the use of modern 
        contraceptives reduces unintended pregnancies and the 
        probability that a woman will have an abortion by 85 percent.
            (5) President George W. Bush has stated that one of the 
        best ways to prevent abortion is by providing quality voluntary 
        family planning programs.
            (6) In developing countries at least 120 million married 
        couples who would like to postpone their next pregnancy, or 
        have no more children, do not have access to or are not using 
        modern contraception.
            (7) In sub-Saharan Africa, 46 percent of women who desire 
        to delay or end childbearing remain without access to voluntary 
        family planning and at risk of unintended pregnancy.
            (8) Each year more than 525,000 women die from causes 
        related to pregnancy and childbirth with 99 percent of these 
        deaths occurring in developing countries. An additional eight 
        million women each year suffer serious health complications 
        from pregnancy and childbirth.
            (9) A lack of birth spacing resulting in birth intervals of 
        9 to 14 months increases the risk of maternal death by 250 
        percent.
            (10) Birth spacing of at least 36 months is associated with 
        the lowest mortality risk for infants and children under five 
        years of age.
            (11) Approximately 10.8 million children under the age of 
        five die each year, more than 30,000 every day, frequently from 
        low birth-weight or from causes related to complications in the 
        mother's pregnancy.
            (12) Providing access to modern contraception in less 
        developed countries could prevent 1.4 million infant deaths and 
        142,000 maternal deaths annually.
            (13) Linking family planning programs with HIV/AIDS 
        prevention, care, and treatment programs helps to meet the 
        multiple health needs of couples while effectively using scarce 
        financial and human resources.
            (14) For HIV-positive women, family planning is the most 
        efficacious and cost-effective intervention to prevent 
        unintended pregnancies, decrease the risk of maternal death, 
        and avoid the transmission of HIV from mother-to-child, 
        premature birth, low birth weight, or infant death.
            (15) Rapid population growth over-stresses vital resources, 
        such as water, agricultural land, forests, and wildlife, 
        contributing to extreme poverty, infectious disease, limited 
        access to education, environmental destruction, food 
        insecurity, and resultant malnutrition.
            (16) Malnutrition in children is a contributing factor to 
        more than one-half of all child mortality, and malnutrition in 
        mothers account for a substantial proportion of neonatal 
        mortality.
            (17) United States-funded family planning programs have 
        been successfully linked with the conservation of natural 
        resources to ease growing population pressures, improve food 
        security, and keep families healthy and communities 
        economically viable.
            (18) Between 2005 and 2050, if family planning needs remain 
        unmet, the population is expected to grow by more than 300 
        percent in the developing countries of Afghanistan, Burkina 
        Faso, Burundi, Chad, the Democratic Republic of the Congo, the 
        Republic of the Congo, Guinea-Bissau, Liberia, Mali, Niger, the 
        Democratic Republic of Timor-Leste, and Uganda.

SEC. 3. SENSE OF CONGRESS.

    It is the sense of Congress that it should be a United States 
policy objective to--
            (1) partner with developing countries to expand access to 
        voluntary family planning programs and the supply of modern 
        contraceptives in order to--
                    (A) meet growing demand to allow couples to achieve 
                their desired family size;
                    (B) reduce maternal and child mortality;
                    (C) reduce unintended pregnancies and resulting 
                abortions;
                    (D) reduce the incidence of HIV transmission from 
                mother-to-child and extend the lives of HIV-positive 
                women thus reducing the number of orphaned children;
                    (E) conserve vital natural resources, including 
                water, agricultural land, and forested lands;
                    (F) improve food security; and
                    (G) enhance opportunities for lasting social and 
                economic development; and
            (2) strengthen public heath initiatives worldwide by 
        provide training, research, and services for a wide variety of 
        modern contraceptives and family planning methods that are 
        designed and implemented based on--
                    (A) community participation;
                    (B) the needs and values of beneficiaries; and
                    (C) adherence to the principles of voluntary 
                participation and informed consent.

SEC. 4. ASSISTANCE TO IMPROVE VOLUNTARY FAMILY PLANNING PROGRAMS IN 
              DEVELOPING COUNTRIES.

    (a) Amendments.--Section 104(b) of the Foreign Assistance Act of 
1961 (22 U.S.C. 2151b(b)) is amended--
            (1) in the first sentence, by striking ``In order to'' and 
        inserting the following:
            ``(1) In general.--In order to''; and
            (2) by adding at the end the following new paragraph:
            ``(2) Assistance to improve voluntary family planning 
        programs.--
                    ``(A) In general.--The President, acting through 
                the Administrator of the United States Agency for 
                International Development, is authorized to provide 
                assistance, on such terms and conditions as the 
                President may determine, to improve voluntary family 
                planning programs in developing countries.
                    ``(B) Activities supported.--Assistance provided 
                under subparagraph (A) shall, to the maximum extent 
                practicable, be used to--
                            ``(i) improve public knowledge of voluntary 
                        family planning programs, including the 
                        availability of modern contraceptives and the 
                        health, economic, and natural resource benefits 
                        of voluntary family planning for individuals, 
                        families, and communities;
                            ``(ii) support a wide range of public and 
                        private voluntary family planning programs, 
                        including networks for community-based and 
                        subsidized commercial distribution of modern 
                        contraceptives;
                            ``(iii) expand formal and informal training 
                        for health care providers, health educators, 
                        including peer educators and outreach workers, 
                        managers, traditional birth attendants, 
                        counselors, and community-based distribution 
                        agents;
                            ``(iv) provide improved coordination 
                        between voluntary family planning programs and 
                        programs that receive United States Government 
                        assistance for the prevention of HIV/AIDS and 
                        other sexually transmitted infections, the 
                        prevention of mother-to-child HIV transmission, 
                        and the testing, treatment, and care of persons 
                        infected with HIV/AIDS and affected by HIV/AIDS 
                        to strengthen activities under such programs 
                        and enhance the cost-effectiveness of such 
                        programs; and
                            ``(v) strengthen supply chain logistics for 
                        the procurement and reliable distribution of 
                        safe and effective modern contraceptives, 
                        including coordination with the supply chain 
                        for HIV/AIDS prevention, care, and treatment, 
                        to allow for maximum efficiency and cost-
                        savings.
                    ``(C) Priority.--In providing assistance under this 
                paragraph, priority shall be given to developing 
                countries with acute family planning and maternal 
                health needs based on criteria such as--
                            ``(i) the level of unmet need for voluntary 
                        family planning and modern contraceptives;
                            ``(ii) fertility rates;
                            ``(iii) high-risk birth rates;
                            ``(iv) the number of births unattended by 
                        skilled attendants;
                            ``(v) maternal mortality rates;
                            ``(vi) rates of mortality for infants and 
                        children under the age of five;
                            ``(vii) abortion rates;
                            ``(viii) the level of HIV/AIDS in women of 
                        reproductive age; and
                            ``(ix) additional criteria or country 
                        conditions, such as conflict, humanitarian 
                        crisis, large populations of refugees or 
                        internally displaced persons, or areas in which 
                        population growth threatens food security, 
                        vital natural resources, biodiversity, or 
                        endangered species.
                    ``(D) Definitions.--In this paragraph:
                            ``(i) AIDS.--The term `AIDS' has the 
                        meaning given the term in section 104A(g)(1) of 
                        this Act.
                            ``(ii) HIV.--The term `HIV' has the meaning 
                        given the term in section 104A(g)(2) of this 
                        Act.
                            ``(iii) HIV/AIDS.--The term `HIV/AIDS' has 
                        the meaning given the term in section 
                        104A(g)(3) of this Act.''.
    (b) Effective Date.--The authority to provide assistance under 
section 104(b)(2) of the Foreign Assistance Act of 1961, as added by 
subsection (a), applies with respect to fiscal year 2007 and subsequent 
fiscal years.

SEC. 5. REPORT.

    (a) Report.--Not later than one year after the date of the 
enactment of this Act, and biennially thereafter, the President, acting 
through the Administrator of the United States Agency for International 
Development, shall transmit to the Committee on International Relations 
of the House of Representatives and the Committee on Foreign Relations 
of the Senate a report on the implementation of section 104(b)(2) of 
the Foreign Assistance Act of 1961 (as added by section 4(a)).
    (b) Contents.--The report shall include--
            (1) a description of efforts to implement the policies set 
        forth in section 104(b)(2) of the Foreign Assistance Act of 
        1961;
            (2) a description of the programs established pursuant to 
        such section; and
            (3) a detailed assessment of the impact of programs 
        established pursuant to such section, including--
                    (A) an estimate of annual expenditures on modern 
                contraceptive commodities and activities in support of 
                voluntary family planning programs on a country-by-
                country basis, to be based on information supplied by 
                national governments, donor agencies, and private 
                sector entities, to the maximum extent practicable;
                    (B) an assessment by country of the current unmet 
                need for, availability, and use of modern 
                contraception;
                    (C) an assessment of prior year and proposed 
                allocations of modern contraceptives in voluntary 
                family planning assistance by country, which describes 
                how each country's allocation meets the country's 
                needs; and
                    (D) a description of the quality of funded 
                voluntary family planning programs, as measured by 
                survey data or best available estimates, including--
                            (i) types of modern contraceptive methods 
                        offered to significant subgroups (defined by 
                        age, gender, income, and health profile, among 
                        others) on a reliable basis;
                            (ii) information provided to beneficiaries 
                        to enable decision making regarding benefits, 
                        risks, and efficacy of modern contraceptives;
                            (iii) mechanisms to encourage 
                        sustainability of voluntary family planning 
                        programs; and
                            (iv) voluntary family planning programs 
                        that are effective in responding to individual 
                        health needs of beneficiaries.

SEC. 6. AUTHORIZATION OF APPROPRIATIONS.

    There are authorized to be appropriated to the President to carry 
out section 104(b)(2) of the Foreign Assistance Act of 1961, as added 
by section 4(a) of this Act--
            (1) $600,000,000 for fiscal year 2007;
            (2) $700,000,000 for fiscal year 2008;
            (3) $800,000,000 for fiscal year 2009;
            (4) $900,000,000 for fiscal year 2010; and
            (5) $1,000,000,000 for fiscal year 2011.
                                 <all>