[Congressional Bills 109th Congress]
[From the U.S. Government Publishing Office]
[H.R. 4222 Introduced in House (IH)]







109th CONGRESS
  1st Session
                                H. R. 4222

To provide assistance to improve the health of newborns, children, and 
        mothers in developing countries, and for other purposes.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                            November 3, 2005

 Ms. McCollum of Minnesota (for herself, Mr. Shays, Mrs. Christensen, 
  Ms. Jackson-Lee of Texas, Mr. McGovern, Mr. Leach, Ms. DeLauro, Mr. 
Berman, Mr. Payne, Mr. Grijalva, Mr. McDermott, Mr. Sanders, Mr. Honda, 
 Mrs. Maloney, Mr. Case, Mr. McNulty, Mrs. Johnson of Connecticut, and 
  Mr. Larson of Connecticut) introduced the following bill; which was 
          referred to the Committee on International Relations

_______________________________________________________________________

                                 A BILL


 
To provide assistance to improve the health of newborns, children, and 
        mothers 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 ``Child Health Investment for Long-
term Development (CHILD and Newborn) Act of 2005''.

SEC. 2. FINDINGS AND PURPOSES.

    (a) Findings.--Congress finds the following:
            (1) Around the world, approximately 10.8 million children 
        under the age of five die each year, more than 30,000 per day, 
        almost all in the developing world.
            (2) Each year in the developing world, four million 
        newborns die in their first four weeks of life.
            (3) Sub-Saharan Africa, with only 10 percent of the world's 
        population, accounts for 43 percent of all deaths among 
        children under the age of five.
            (4) Countries such as Afghanistan, Angola and Niger 
        experience extreme levels of child mortality, with 25 percent 
        of children dying before their fifth birthday.
            (5) For children under the age of five in the developing 
        world, preventable or treatable diseases, such as measles, 
        tetanus, diarrhea, pneumonia, and malaria, are the most common 
        causes of death.
            (6) Throughout the developing world, the lack of basic 
        health services, clean water, adequate sanitation, and proper 
        nutrition contribute significantly to child mortality.
            (7) Hunger and malnutrition contribute to over five million 
        child deaths annually.
            (8) The lack of low-cost antibiotics and anti-malarial 
        drugs contribute to three million child deaths each year.
            (9) Lack of access to health services results in 30 million 
        children under the age of one year going without necessary 
        immunizations.
            (10) Every year an estimated 250,000 to 500,000 vitamin A-
        deficient children become blind, with one-half of such children 
        dying within 12 months of losing their sight.
            (11) Iron deficiency, affecting over 30 percent of the 
        world's population, causes premature birth, low birth weight, 
        and infections, elevating the risk of death in children.
            (12) Two-thirds of deaths of children under five years of 
        age, or 7.1 million children, including three million newborn 
        deaths, could be prevented by low-cost, low-tech health and 
        nutritional interventions.
            (13) Exclusive breastfeeding--giving only breast milk for 
        the first six months of life--could prevent an estimated 1.3 
        million newborn and infant deaths each year, primarily by 
        protecting against diarrhea and pneumonia.
            (14) An additional two million lives could be saved 
        annually by providing oral-rehydration therapy prepared with 
        clean water.
            (15) During the 1990s, successful immunization programs 
        reduced polio by 99 percent, tetanus deaths by 50 percent, and 
        measles cases by 40 percent.
            (16) Between 1998 and 2000, distribution of low-cost 
        vitamin A supplements saved an estimated one million lives.
            (17) Expansion of clinical care of newborns and mothers, 
        such as clean delivery by skilled attendants, emergency 
        obstetric care, and neonatal resuscitation, can avert 50 
        percent of newborn deaths.
            (18) Keeping mothers healthy is essential for child 
        survival because illness, complications, or maternal death 
        during or following pregnancy increases the risk for death in 
        newborns and infants.
            (19) 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.
            (20) The lifetime risk of an African woman dying from a 
        complication related to pregnancy or childbirth is 1 in 16, 
        while the same risk for a woman in a developed country is 1 in 
        2,800.
            (21) Risk factors for maternal death in developing 
        countries include early pregnancy and childbirth, closely 
        spaced births, infectious diseases, malnutrition, and 
        complications during childbirth.
            (22) Reducing maternal mortality requires birth spacing, 
        access to preventive care, skilled birth attendants, and 
        emergency obstetric care.
            (23) The role of the United States in promoting child 
        survival and maternal health over the past three decades has 
        resulted in millions of lives being saved around the world.
            (24) In 2000, the United States joined 188 other countries 
        in supporting eight Millennium Development Goals designed to 
        achieve ``a more peaceful, prosperous and just world''.
            (25) Two of the Millennium Development Goals call for a 
        reduction in the mortality rate of children under the age of 
        five by two-thirds and a reduction in maternal deaths by three-
        quarters by 2015.
            (26) On September 14, 2005, President George W. Bush stated 
        before the leaders of the world: ``To spread a vision of hope, 
        the United States is determined to help nations that are 
        struggling with poverty. We are committed to the Millennium 
        Development Goals.''.
    (b) Purposes.--The purposes of this Act are to--
            (1) authorize assistance to improve the health of newborns, 
        children, and mothers in developing countries, including by 
        strengthening the capacity of health systems and health 
        workers;
            (2) develop and implement a strategy to improve the health 
        of newborns, children, and mothers, including reducing child 
        and maternal mortality, in developing countries;
            (3) to establish a task force to assess, monitor, and 
        evaluate the progress and contributions of relevant departments 
        and agencies of the Government of the United States in 
        achieving the United Nations Millennium Development Goals by 
        2015 for reducing the mortality of children under the age of 
        five by two-thirds and reducing maternal mortality by three-
        quarters in developing countries.

SEC. 3. ASSISTANCE TO IMPROVE THE HEALTH OF NEWBORNS, CHILDREN, AND 
              MOTHERS IN DEVELOPING COUNTRIES.

    (a) In General.--Chapter 1 of part I of the Foreign Assistance Act 
of 1961 (22 U.S.C. 2151 et seq.) is amended--
            (1) in section 104(c)--
                    (A) by striking paragraphs (2) and (3); and
                    (B) by redesignating paragraph (4) as paragraph 
                (2);
            (2) by redesignating sections 104A, 104B, and 104C as 
        sections 104B, 104C, and 104D, respectively; and
            (3) by inserting after section 104 the following new 
        section:

``SEC. 104A. ASSISTANCE TO IMPROVE THE HEALTH OF NEWBORNS, CHILDREN, 
              AND MOTHERS.

    ``(a) Authorization.--Consistent with section 104(c), the President 
is authorized to furnish assistance, on such terms and conditions as 
the President may determine, to improve the health of newborns, 
children, and mothers in developing countries.
    ``(b) Activities Supported.--Assistance provided under subsection 
(b) shall, to the maximum extent practicable, be used to carry out the 
following activities:
            ``(1) Activities to strengthen the capacity of health 
        systems in developing countries, including training for 
        clinicians, nurses, technicians, sanitation and public health 
        workers, community-based health workers, midwives and birth 
        attendants, peer educators, and private sector enterprises.
            ``(2) Activities to provide health care access to 
        underserved and marginalized populations.
            ``(3) Activities to ensure the supply, logistical support, 
        and distribution of essential drugs, vaccines, commodities, and 
        equipment to regional, district, and local levels.
            ``(4) Activities to educate underserved and marginalized 
        populations to seek health care when appropriate, including 
        clinical and community-based activities.
            ``(5) Activities to integrate and coordinate assistance 
        provided under this section with existing health programs for--
                    ``(A) the prevention of the transmission of HIV 
                from mother-to-child and other HIV/AIDS counseling, 
                care, and treatment activities;
                    ``(B) malaria;
                    ``(C) tuberculosis; and
                    ``(D) child spacing.
            ``(6) Activities to expand access to safe water and 
        sanitation.
            ``(7) Activities to expand the use of and technical support 
        for appropriate technology to reduce acute respiratory 
        infection from firewood smoke inhalation.
    ``(c) Guidelines.--To the maximum extent practicable, programs, 
projects, and activities carried out using assistance provided under 
this section shall be--
            ``(1) carried out through private and voluntary 
        organizations, as well as faith-based organizations, giving 
        priority to organizations that demonstrate effectiveness and 
        commitment to improving the health of newborns, children, and 
        mothers;
            ``(2) carried out with input by host countries, including 
        civil society and local communities, as well as other donors 
        and multilateral organizations;
            ``(3) carried out with input by beneficiaries and other 
        directly affected populations, especially women and 
        marginalized communities; and
            ``(4) designed to build the capacity of host country 
        governments and civil society organizations.
    ``(d) Annual Report.--Not later than January 31 of each year, the 
President shall transmit to Congress a report on the implementation of 
this section for the prior fiscal year.
    ``(e) Definitions.--In this section:
            ``(1) AIDS.--The term `AIDS' has the meaning given the term 
        in section 104B(g)(1) of this Act.
            ``(2) HIV.--The term `HIV' has the meaning given the term 
        in section 104B(g)(2) of this Act.
            ``(3) HIV/AIDS.--The term `HIV/AIDS' has the meaning given 
        the term in section 104B(g)(3) of this Act. ''.
    (b) Conforming Amendments.--The Foreign Assistance Act of 1961 (22 
U.S.C. 2151 et seq.) is amended--
            (1) in section 104(c)(2) (as redesignated by subsection 
        (a)(1)(B) of this section), by striking ``and 104C'' and 
        inserting ``104C, and 104D'';
            (2) in section 104B (as redesignated by subsection (a)(2) 
        of this section)--
                    (A) in subsection (c)(1), by inserting ``and 
                section 104A'' after ``section 104(c)'';
                    (B) in subsection (e)(2), by striking ``section 
                104B, and section 104C'' and inserting ``section 104C, 
                and section 104D''; and
                    (C) in subsection (f), by striking ``section 
                104(c), this section, section 104B, and section 104C'' 
                and inserting ``section 104(c), section 104A, this 
                section, section 104C, and section 104D'';
            (3) in subsection (c) of section 104C (as redesignated by 
        subsection (a)(2) of this section), by inserting ``and section 
        104A'' after ``section 104(c)'';
            (4) in subsection (c) of section 104D (as redesignated by 
        subsection (a)(2) of this section), by inserting ``and section 
        104A'' after ``section 104(c)''; and
            (5) in the first sentence of section 119(c), by striking 
        ``section 104(c)(2), relating to Child Survival Fund'' and 
        inserting ``section 104A''.

SEC. 4. DEVELOPMENT OF STRATEGY TO IMPROVE THE HEALTH OF NEWBORNS, 
              CHILDREN, AND MOTHERS IN DEVELOPING COUNTRIES.

    (a) Development of Strategy.--The President shall develop a 
comprehensive strategy to improve the health of newborns, children, and 
mothers, including reducing newborn, child, and maternal mortality, in 
developing countries.
    (b) Components.--The strategy developed pursuant to subsection (a) 
shall include the following:
            (1) Programmatic areas and interventions providing maximum 
        health benefits to populations at risk as well as maximum 
        reduction in mortality, including--
                    (A) costs and benefits of programs and 
                interventions; and
                    (B) investments needed in identified programs and 
                interventions to achieve the greatest results.
            (2) An identification of countries with priority needs for 
        the five-year period beginning on the date of the enactment of 
        this Act based on--
                    (A) the neonatal mortality rate;
                    (B) the mortality rate of children under the age of 
                five;
                    (C) the maternal mortality rate;
                    (D) the percentage of women and children with 
                limited or no access to basic health care; and
                    (E) additional criteria for evaluation such as--
                            (i) the percentage of one-year old children 
                        who are fully immunized;
                            (ii) the percentage of children under the 
                        age of five who sleep under insecticide-treated 
                        bed nets;
                            (iii) the percentage of children under the 
                        age of five with fever treated with anti-
                        malarial drugs;
                            (iv) the percentage of children under the 
                        age of five who are covered by vitamin A 
                        supplementation;
                            (v) the percentage of children under the 
                        age of five with diarrhea who are receiving 
                        oral-rehydration therapy and continued feeding;
                            (vi) the percentage of children under the 
                        age of five with pneumonia who are receiving 
                        appropriate care;
                            (vii) the percentage of the population with 
                        access to improved sanitation facilities;
                            (viii) the percentage of the population 
                        with access to safe drinking water;
                            (ix) the percentage of children under the 
                        age of five who are underweight for their age;
                            (x) the percentage of births attended by 
                        skilled health care personnel;
                            (xi) the percentage of women with access to 
                        emergency obstetric care;
                            (xii) the potential for implementing 
                        newborn, child, and maternal health 
                        interventions at scale; and
                            (xiii) the demonstrated commitment of 
                        countries to newborn, child, and maternal 
                        health.
            (3) A description of how United States assistance 
        complements and leverages efforts by other donors, as well as 
        builds capacity and self-sufficiency among recipient countries.
            (4) An expansion of the Child Survival and Health Grants 
        Program of the United States Agency for International 
        Development to provide additional support programs and 
        interventions determined to be efficacious and cost-effective 
        improving health and reducing mortality.
            (5) Enhanced coordination among relevant departments and 
        agencies of the Government of the United States engaged in 
        activities to improve the health of newborns, children, and 
        mothers in developing countries.
    (c) Report.--Not later than 180 days after the date of the 
enactment of this Act, the President shall transmit to Congress a 
report that contains the strategy described in this section.

SEC. 5. INTERAGENCY TASK FORCE ON CHILD SURVIVAL AND MATERNAL HEALTH IN 
              DEVELOPING COUNTRIES.

    (a) Establishment.--There is established a task force to be known 
as the Interagency Task Force on Child Survival and Maternal Health in 
Developing Countries (in this section referred to as the ``Task 
Force'').
    (b) Duties.--
            (1) In general.--The Task Force shall assess, monitor, and 
        evaluate the progress and contributions of relevant departments 
        and agencies of the Government of the United States in 
        achieving the Millennium Development Goals by 2015 for reducing 
        the mortality of children under the age of five by two-thirds 
        and reducing maternal mortality by three-quarters in developing 
        countries, including by--
                    (A) identifying and evaluating programs and 
                interventions that directly or indirectly contribute to 
                the reduction of child and maternal mortality rates;
                    (B) assessing effectiveness of programs, 
                interventions, and strategies toward achieving the 
                maximum reduction of child and maternal mortality 
                rates;
                    (C) assessing the level of coordination among 
                relevant departments and agencies of the Government of 
                the United States, the international community, 
                international organizations, faith-based organizations, 
                academic institutions, and the private sector;
                    (D) assessing the contributions made by United 
                States-funded programs toward achieving the Millennium 
                Development Goals;
                    (E) identifying the bilateral efforts of other 
                nations and multilateral efforts toward achieving the 
                Millennium Development Goals; and
                    (F) preparing the annual report required by 
                subsection (f).
            (2) Consultation.--To the maximum extent practicable, the 
        Task Force shall consult with individuals with expertise in the 
        matters to be considered by the Task Force who are not officers 
        or employees of the Government of the United States, including 
        representatives of United States-based nongovernmental 
        organizations (including faith-based organizations and private 
        foundations), academic institutions, private corporations, the 
        United Nations Children's Fund (UNICEF), and the World Bank.
    (c) Membership.--
            (1) Number and appointment.--The Task Force shall be 
        composed of the following members:
                    (A) The Administrator of the United States Agency 
                for International Development.
                    (B) The Assistant Secretary of State for 
                Population, Refugees and Migration.
                    (C) The Coordinator of United States Government 
                Activities to Combat HIV/AIDS Globally.
                    (D) The Director of the Office of Global Health 
                Affairs of the Department of Health and Human Services.
                    (E) The Under Secretary for Food, Nutrition and 
                Consumer Services of the Department of Agriculture.
                    (F) The Chief Executive Officer of the Millennium 
                Challenge Corporation.
                    (G) The Director of the Peace Corps.
                    (H) Other officials of relevant departments and 
                agencies of the Federal Government who shall be 
                appointed by the President.
            (2) Chairperson.--The Administrator of the United States 
        Agency for International Development shall serve as chairperson 
        of the Task Force.
    (d) Meetings.--The Task Force shall meet on a regular basis, not 
less often than quarterly, on a schedule to be agreed upon by the 
members of the Task Force, and starting not later than 90 days after 
the date of the enactment of this Act.
    (e) Definition.--In this subsection, the term ``Millennium 
Development Goals'' means the key development objectives described in 
the United Nations Millennium Declaration, as contained in United 
Nations General Assembly Resolution 55/2 (September 2000).
    (f) Report.--Not later than 120 days after the date of the 
enactment of this Act, and not later than April 30 of each year 
thereafter, the Task Force shall submit to Congress and the President a 
report on the implementation of this section.

SEC. 6. AUTHORIZATION OF APPROPRIATIONS.

    (a) In General.--There are authorized to be appropriated to carry 
out this Act, and the amendments made by this Act, $660,000,000 for 
fiscal year 2007 and $1,200,000,000 for each of the fiscal years 2008 
through 2011.
    (b) Availability of Funds.--Amounts appropriated pursuant to the 
authorization of appropriations under subsection (a) are authorized to 
remain available until expended.
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