[Congressional Bills 113th Congress]
[From the U.S. Government Publishing Office]
[S. 2853 Introduced in Senate (IS)]

113th CONGRESS
  2d Session
                                S. 2853

 To implement policies to end preventable maternal, newborn, and child 
                            deaths globally.


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

                           September 18, 2014

  Mr. Coons (for himself, Mr. Graham, and Mr. Cardin) introduced the 
 following bill; which was read twice and referred to the Committee on 
                           Foreign Relations

_______________________________________________________________________

                                 A BILL


 
 To implement policies to end preventable maternal, newborn, and child 
                            deaths globally.

    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 ``Accelerating Action in Maternal and 
Child Health Act of 2014''.

SEC. 2. PURPOSE.

    The purpose of this Act is to provide tools for the United States 
Government to use to accelerate the reduction of preventable maternal, 
newborn, and child deaths in 24 United States Agency for International 
Development (USAID) focus countries by 2020, saving 15,000,000 children 
and 600,000 mothers.

SEC. 3. FINDINGS.

    Congress makes the following findings:
            (1) Over the past 2 decades, child mortality has reduced by 
        nearly 50 percent and maternal mortality has reduced by 40 
        percent, thanks in large part to United States Government 
        action and intervention.
            (2) In the last 3 years, 24 priority countries--of which 16 
        are in Africa--have achieved an 8 percent reduction in under-5 
        mortality, saving 500,000 lives.
            (3) The report ``Acting on the Call: Ending Preventable 
        Child and Maternal Deaths'' developed by USAID provides a 
        critical foundation of evidence, knowledge, modeling, and 
        policy development on ending maternal, newborn, and child 
        deaths worldwide.
            (4) To achieve Millennium Development Goal 4--to reduce 
        child mortality by \2/3\ between 1990 and 2015--on time, the 
        global annual rate of reduction in under-5 mortality would need 
        to rise to 15.6 percent from 2012 through 2015, much faster 
        than the 3.9 percent achieved from 2005 through 2012.
            (5) According to the World Health Organization (WHO), every 
        year 6,600,000 children under the age of 5--primarily infants--
        die from preventable or treatable causes, and more than 800 
        women die every day from complications during pregnancy and 
        childbirth.
            (6) The vast majority of these deaths occur in the 
        developing world and countries in Africa have the highest 
        burden.
            (7) The highest rates of child mortality are still in sub-
        Saharan Africa, with an under-5 mortality rate of 98 deaths per 
        1,000 live births--more than 15 times the average for developed 
        regions.
            (8) Investing in women and children reduces poverty, 
        stimulates economic growth, and most importantly, saves lives.
            (9) Health products, such as vaccines and treatments, have 
        contributed significantly to recent successes in child and 
        maternal survival globally. New approaches and technologies are 
        critically needed to accelerate progress toward ending 
        preventable maternal and child deaths.
            (10) The WHO identifies the following leading causes of 
        maternal, newborn, and child mortality:
                    (A) Leading causes of maternal mortality in low-
                income countries include post-partum bleeding, 
                infection, and hypertension.
                    (B) Newborn deaths account for approximately 44 
                percent of deaths among children under age 5 and are 
                predominantly caused by infections, premature birth, 
                and asphyxia.
                    (C) Most deaths of children under the age of 5 are 
                a result of preventable causes, such as respiratory 
                infections (commonly from pneumonia), diarrhea, and 
                malaria.
                    (D) Malnutrition is the underlying contributing 
                factor in about 45 percent of all child deaths, making 
                children more vulnerable to severe diseases.

SEC. 4. STATEMENT OF POLICY.

    It is the policy of the United States, in partnership with host 
governments, international financial institutions, nongovernmental 
organizations, faith-based organizations, and the private sector, to 
establish a comprehensive, coordinated, integrated strategy to combat 
the leading causes of maternal, newborn, and child mortality globally 
by--
            (1) building on progress and success to date;
            (2) scaling up the most effective evidence-based 
        interventions with a focus on country ownership;
            (3) focusing on USAID's 24 priority countries;
            (4) streamlining existing resources and scaling up 
        increased targeted resources;
            (5) increasing transparency and accountability; and
            (6) creating innovative new public-private financing 
        mechanisms.

SEC. 5. STRATEGY.

    (a) In General.--The President shall establish a strategy to 
accelerate action in each of the 24 priority countries set forth in 
section 7, building on the evidence outlined in USAID's ``Acting on the 
Call: Ending Preventable Child and Maternal Deaths''. The strategy will 
use the current modeling and data that outlines the most proven 
effective interventions. The strategy shall further strengthen the 
capability of the United States to be an effective leader in maternal, 
newborn, and child health, particularly in Africa, and will be a first 
step toward a broader, concerted effort to end maternal, newborn, and 
child deaths worldwide.
    (b) Elements.--The strategy established under subsection (a) 
shall--
            (1) include specific objectives, multisectoral approaches, 
        and specific strategies to address the leading causes of death 
        among mothers during pregnancy, childbirth, and post-delivery; 
        newborns in their first 28 days; and children under the age of 
        5;
            (2) clarify the responsibilities of the country, the 
        implementing organization, and the United States in the 
        achievement of such objectives;
            (3) include regular benchmarks to measure, where 
        appropriate, progress toward achieving such objectives;
            (4) utilize data and modeling to implement the most 
        effective interventions for saving 15,000,000 children and 
        600,000 mothers;
            (5) illustrate the result of coordination among relevant 
        executive branch agencies, foreign governments, and 
        international organizations;
            (6) provide projected levels of resources needed to achieve 
        the stated objectives;
            (7) expand public-private partnerships for research and 
        innovation and for leveraging resources in new and innovative 
        ways; and
            (8) use open, fair, and competitive procedures wherever 
        appropriate and possible in the administration, execution, and 
        evaluation of the program.
    (c) Targeted Services.--The strategy established under subsection 
(a) should focus on the following evidence-based categories of 
intervention:
            (1) Safe motherhood and newborn survival, including--
                    (A) prenatal and postnatal care for mothers and 
                newborns;
                    (B) quality care during labor and delivery, 
                including in emergencies; and
                    (C) education on healthy timing and spacing of 
                pregnancies.
            (2) Healthy households and schools, including Water, 
        Sanitation, and Hygiene (WASH).
            (3) Nutrition, including--
                    (A) maternal and child nutrition during the first 
                1,000 days; and
                    (B) prevention of maternal malnutrition.
            (4) Healthy childhood, including--
                    (A) vaccines for the leading causes of maternal, 
                newborn, and child deaths;
                    (B) prevention and treatment for pneumonia and 
                diarrhea;
                    (C) prevention of mother-to-child transmission of 
                HIV (PMTCT);
                    (D) prevention and treatment of malaria; and
                    (E) capacity-building of health professionals.

SEC. 6. ESTABLISHMENT OF AN INNOVATIVE PUBLIC-PRIVATE FINANCING 
              MECHANISM.

    The United States Government shall establish a pilot program for 
innovative financing mechanisms for delivering maternal, newborn, and 
child health interventions in the 24 priority countries set forth in 
section 7 based on the specific recommendations outlined by the 
convening of high-level global experts at the 2014 United Nations 
General Assembly. The innovative financing framework will establish a 
method to mobilize capital for health utilizing tools, including loans 
and loan guarantees, volume guarantees, development impact bonds, or 
partner government taxes, levies, fees, and funds.

SEC. 7. PRIORITY COUNTRIES.

    (a) In General.--Based on the global target list developed by 
USAID, the priority countries for receiving maternal and child health 
programming under this Act are the following:
            (1) Afghanistan.
            (2) Bangladesh.
            (3) The Democratic Republic of the Congo (DRC).
            (4) Ethiopia.
            (5) Ghana.
            (6) Haiti.
            (7) India.
            (8) Indonesia.
            (9) Kenya.
            (10) Liberia.
            (11) Madagascar.
            (12) Malawi.
            (13) Mali.
            (14) Mozambique.
            (15) Nepal.
            (16) Nigeria.
            (17) Pakistan.
            (18) Rwanda.
            (19) Senegal.
            (20) South Sudan.
            (21) Tanzania.
            (22) Uganda.
            (23) Yemen.
            (24) Zambia.
    (b) Eligibility Criteria.--The United States Government should give 
preference to applying mechanisms under this Act to the countries 
listed under subsection (a) that have reached or made progress towards 
2001 Abuja Declaration commitments involving pledges to increase 
government funding for health to at least 15 percent within the next 5 
years. A candidate country should be also considered to be an eligible 
country by demonstrating a commitment to--
            (1) peaceful and democratic governance;
            (2) civil society engagement;
            (3) economic freedom; and
            (4) investments in the people of such country, particularly 
        in maternal, newborn, and child health.

SEC. 8. PROGRESS REPORT.

    Beginning 2 years after the date of the enactment of this Act, the 
President shall provide an annual progress report to Congress on 
activities under this Act, including--
            (1) data on mechanisms implemented under this Act, 
        including a description of how they are designed, managed, and 
        monitored and evaluated;
            (2) how many mechanisms are implemented and where; and
            (3) the results of implementation of such mechanisms, and 
        recommendations for improving these mechanisms to ensure future 
        growth and success.

SEC. 9. AUTHORIZATION OF APPROPRIATIONS.

    There are authorized to be appropriated to carry out this Act such 
sums as may be necessary for each of fiscal years 2015 through 2019, to 
remain available until expended.
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