1.This Act may be cited as the Child
Health Investment for Long-term Development (CHILD and Newborn) Act of
2006
.
2.
(a)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)Birth spacing, access to preventive care,
skilled birth attendants, and emergency obstetric care can help reduce maternal
mortality.
(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)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.
3.Assistance to
improve the health of newborns, children, and mothers in developing
countries
(a)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:
104A.Assistance to
improve the health of newborns, children, and mothers
(a)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)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)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)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)In
this section:
(1)The
term AIDS
has the meaning given the term in section 104B(g)(1)
of this Act.
(2)The
term HIV
has the meaning given the term in section 104B(g)(2) of
this Act.
(3)The
term HIV/AIDS
has the meaning given the term in section
104B(g)(3) of this
Act.
.
(b)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
.
4.Development of
strategy to improve the health of newborns, children, and mothers in developing
countries
(a)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)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 in 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)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.
5.Interagency Task
Force on Child Survival and Maternal Health in Developing Countries
(a)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)
(1)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)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)
(1)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)The Administrator of the United States
Agency for International Development shall serve as chairperson of the Task
Force.
(d)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)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)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.
6.Authorization of
appropriations
(a)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)Amounts appropriated
pursuant to the authorization of appropriations under subsection (a) are
authorized to remain available until expended.