[Congressional Bills 114th Congress]
[From the U.S. Government Publishing Office]
[S. 1911 Introduced in Senate (IS)]

114th CONGRESS
  1st Session
                                S. 1911

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


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

                             July 30, 2015

Ms. Collins (for herself and Mr. Coons) 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 ``Reach Every Mother and Child Act of 
2015''.

SEC. 2. PURPOSE.

    The purpose of this Act is to authorize coordination of a whole-of-
government strategic approach to accelerate action by the United States 
to assist developing countries reach the goal of ending preventable 
maternal, newborn, and child deaths by 2035.

SEC. 3. 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 Relations and the 
                Committee on Appropriations of the Senate; and
                    (B) the Committee on Foreign Affairs and the 
                Committee on Appropriations of the House of 
                Representatives.
            (3) Coordinator.--The term ``Coordinator'' means the 
        Maternal and Child Survival Coordinator established under 
        section 6.
            (4) Target countries.--The term ``target countries'' means 
        specific countries have the greatest need and highest burden 
        for maternal and child health interventions, taking into 
        consideration countries that--
                    (A) have high-need communities in fragile and poor 
                States;
                    (B) are located in regions with weak health 
                systems; and
                    (C) have governments that have demonstrated the 
                political will necessary for maternal and child efforts 
                to be sustainable and effective.

SEC. 4. STATEMENT OF POLICY.

    It is the policy of the United States, in partnership with 
developing governments, other donor country governments, international 
financial institutions, nongovernmental organizations, faith-based 
organizations, multilateral organizations, and the private sector, to 
establish and implement a coordinated, integrated, whole-of-government 
strategy to combat the leading causes of maternal, newborn, and child 
mortality 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) designing, implementing, monitoring, and evaluating 
        programs in a way that increases the sustainability and 
        ownership of the programs and improves outcomes in target 
        countries;
            (4) focusing on target countries and other areas of focus;
            (5) streamlining existing resources and scaling up proven 
        interventions;
            (6) increasing transparency and accountability;
            (7) supporting the development and scale up of innovative 
        tools and approaches to accelerate progress toward ending 
        preventable maternal, newborn, and child deaths;
            (8) creating innovative public-private financing 
        mechanisms;
            (9) requiring that grants, contracts, and cooperative 
        agreements for ending preventable maternal, newborn, and child 
        deaths include targets for increased implementation of proven 
        interventions and strengthening health systems as appropriate, 
        including the establishment of baseline measurements from which 
        to quantify progress; and
            (10) accelerating progress towards self-sufficiency for 
        maternal, newborn, and child health and survival programs in 
        target countries and other areas of focus.

SEC. 5. STRATEGY.

    (a) In General.--The President shall establish an inter-agency 
working group, led by the Child and Maternal Survival Coordinator at 
the United States Agency for International Development (USAID) and 
establish and implement, not later than one year after the date of the 
enactment of this Act, a coordinated, whole-of-government, ten-year 
strategy to achieve, with partner countries and donors, the goal of 
ending preventable maternal, newborn, and child deaths by 2035.
    (b) Elements.--The strategy established under subsection (a) 
shall--
            (1) set outcome-based targets to achieve the goals of the 
        strategy and ascertain baseline data relevant for each target 
        country and for all areas of focus and programming as of the 
        date of the release of the strategy;
            (2) utilize existing, reliable data and modeling to enable 
        agencies to reach such targets;
            (3) include specific objectives, programs, and approaches 
        to utilize highest impact, evidence-based interventions to 
        address the leading causes of death among women during 
        pregnancy, childbirth, and post-delivery; newborns in their 
        first 28 days; and children under the age of five, building on 
        the evidence outlined in USAID's ``Acting on the Call: Ending 
        Preventable Child and Maternal Deaths'';
            (4) focus on target countries;
            (5) include development and scale-up of new technologies 
        and approaches, including those supported by public-private 
        partnerships for research and innovation;
            (6) ensure coordination within and amongst the relevant 
        executive branch agencies and initiatives, including the United 
        States Agency for International Development, the Department of 
        State, the Department of Health and Human Services, the Centers 
        for Disease Control and Prevention, the National Institutes of 
        Health, the Millennium Challenge Corporation, the Peace Corps, 
        the Department of the Treasury, the Office of the Global AIDS 
        Coordinator, and the President's Malaria Initiative;
            (7) improve coordination and efficiency among relevant 
        executive branch agencies, foreign governments, and 
        international organizations;
            (8) project general levels of resources needed to achieve 
        the strategy's stated objectives;
            (9) identify strategies for leveraging resources in new and 
        innovative ways;
            (10) align with country-driven maternal, newborn, and child 
        health and survival plans and plans of international 
        organizations that will support progress towards self-
        sustainability by partner countries; and
            (11) outline consultations with governments, international 
        financial institutions, nongovernmental organizations, faith-
        based organizations, local and international civil society 
        groups, multilateral organizations, the private sector, and 
        local health workers and professional associations, as 
        appropriate.

SEC. 6. ESTABLISHMENT OF A CHILD AND MATERNAL SURVIVAL COORDINATOR.

    (a) In General.--The President, acting through the Administrator, 
shall designate a current USAID employee serving in a career or non-
career position in the Senior Executive Service or at the level of a 
Deputy Assistant Administrator or higher to serve concurrently as the 
Maternal and Child Survival Coordinator, who shall be responsible for 
overseeing maternal and child health and nutrition funding managed by 
the Bureau of Global Health of USAID and lead the inter-agency working 
group established under section 5.
    (b) Duties.--The Coordinator shall--
            (1) direct the budget, planning, and staffing to implement 
        the projects and programs of maternal and child health and 
        nutrition accounts managed by the Bureau of Global Health at 
        USAID for the purpose of achieving reductions in preventable 
        maternal, newborn, and child deaths;
            (2) lead implementation and revision, not less frequently 
        than once every 10 years, of the strategy established under 
        section 5;
            (3) cooperate with relevant executive branch agencies, 
        governments of partner countries, nongovernmental organizations 
        (including faith-based, community-based and civil society 
        organizations), and private sector entities to carry out the 
        strategy and to align current and future instruments with high-
        impact, evidence-based interventions to save lives;
            (4) provide direction to and oversee grants, contracts, and 
        cooperative agreements with nongovernmental organizations 
        (including faith-based, community-based and civil society 
        organizations) and private sector entities for the purpose of 
        carrying out the strategy; and
            (5) report to the Administrator regarding implementation of 
        the strategy.
    (c) Restriction on Additional or Supplemental Compensation.--The 
responsibilities and specific duties of the Coordinator shall be in 
addition to any other responsibilities or specific duties assigned to 
the individual. The Coordinator shall receive no additional or 
supplemental compensation as a result of carrying out responsibilities 
and duties under this Act.

SEC. 7. ANNUAL REPORTING ON MATERNAL, NEWBORN, AND CHILD SURVIVAL.

    The President shall update Congress on progress made to achieve the 
strategy established under section 5 as well as progress towards the 
goals set forth in USAID's 2014 Acting on the Call report by submitting 
an annual report to the Committee on Foreign Relations of the Senate 
and the Committee on Foreign Affairs of the House of Representatives 
and publish all report data on the Internet website, 
www.foreignassistance.gov (also known as the ``Foreign Assistance 
Dashboard''). The report shall include the following elements:
            (1) Indicators of progress made by United States Government 
        programs carried out under maternal and child health and 
        nutrition accounts managed by the Bureau of Global Health 
        toward improving maternal, newborn, and child health in each 
        target country and overall, including--
                    (A) number of maternal deaths averted;
                    (B) number of deaths averted of newborns in their 
                first 28 days;
                    (C) number of deaths averted of child before their 
                fifth birthday;
                    (D) maternal mortality ratio (per 100,000 live 
                births);
                    (E) under five mortality rate;
                    (F) births attended by skilled health personnel;
                    (G) density of health workforce (number of health 
                professionals per population);
                    (H) descriptions of the measured or estimated 
                impact on maternal, newborn, and child mortality of 
                each on-going program or project; and
                    (I) any other targets identified by the Coordinator 
                or the inter-agency working group as essential to 
                meeting the goals of the President's strategy for 
                ending preventable maternal, newborn, and child deaths.
            (2) Descriptions of how the interventions are designed--
                    (A) to increase activities in target countries;
                    (B) to reach underserved, marginalized, and 
                impoverished populations;
                    (C) to address causes of maternal, newborn, and 
                child mortality with innovative efforts and 
                interventions posed to go to scale;
                    (D) to invest in activities that empower women, 
                support voluntarism, and provide respectful maternity 
                care;
                    (E) to improve transparency and accountability at 
                all levels and include common metrics for tracking 
                progress;
                    (F) to ensure that high impact, evidence-based 
                interventions are prioritized; and
                    (G) to expand access to quality services through 
                community-based approaches and include community 
                accountability measures.
            (3) Assessments of progress made over the reporting period 
        towards improving the indicators set forth under paragraph (1).
            (4) Reporting on each aspect of the strategy established 
        under section 5, including--
                    (A) multi-sectoral approaches, specific strategies, 
                and programming utilizing high impact, evidence-based 
                interventions to address the leading causes of 
                preventable maternal, newborn, and child deaths;
                    (B) activities to develop and scale up new 
                technologies, interventions, or approaches, including 
                those identified by public-private partnerships for 
                research and innovation;
                    (C) coordination and efficiency within and among 
                each agency in the inter-agency working group, foreign 
                governments, nongovernmental organizations, and 
                international organizations;
                    (D) methods used to leverage new financial and 
                other public and private resources in innovative ways; 
                and
                    (E) best practices identified by the executive 
                branch and its inter-agency working group.
            (5) Reporting on grants, contracts, and cooperative 
        agreements awarded, including--
                    (A) a comprehensive list of USAID grants, contracts 
                and cooperative agreements awarded in implementation of 
                the strategy created under this Act; and
                    (B)(i) a description of--
                            (I) the targets for interventions or 
                        services and the baseline against which they 
                        are measured; and
                            (II) the status of progress in meeting the 
                        targets; or
                    (ii) in exceptional circumstances where USAID 
                determines that inclusion of targets or baseline 
                measurements is not reasonably possible, an explanation 
                of how the impact of the grant, contract, agreement or 
                resulting program is being measured.
            (6) Comprehensive and disaggregated information consistent 
        with the United States Government's commitment to implement 
        transparency measures.

SEC. 8. ESTABLISHMENT OF AN INNOVATIVE PUBLIC-PRIVATE FINANCING 
              MECHANISM.

    (a) Establishment of Financing Framework.--The United States 
Government, through USAID and other relevant executive branch agencies 
identified by the Coordinator and the inter-agency working group, shall 
develop a financing framework to leverage public and private capital to 
expand delivery of high-impact, evidence-based interventions for 
maternal, newborn, and child health. The framework shall also set clear 
expectations for co-financing, where appropriate, to increase domestic 
investment in maternal, newborn, and child survival with the goal of 
assisting countries in moving towards financial self-sufficiency for 
such programs.
    (b) Use of Framework.--
            (1) In general.--In addition to existing bilateral and 
        multilateral assistance for maternal, newborn, and child 
        survival, the United States Government is authorized to utilize 
        the tools outlined in the framework, as well as other 
        innovative financing mechanisms identified and approved by the 
        inter-agency working group, to help countries achieve clear 
        results, exhibit transparency in the use of funds, encourage 
        new domestic and international financing entities, and leverage 
        new and additional public, private, and philanthropic funds for 
        maternal, newborn, and child health and survival in partner 
        countries.
            (2) Tools and approaches.--These tools and approaches 
        include development impact bonds, loan guarantees, revolving 
        funds, working capital funds, performance-based financing 
        mechanisms, public-private partnerships, and other similar 
        financing or monetization mechanisms that leverage funding to 
        expand interventions that save lives and improve health and 
        survival.
            (3) Authorities.--In addition to currently held 
        authorities, USAID and other relevant executive branch agencies 
        of the United States Government, acting on their own or in 
        partnership with developing countries, other donor countries, 
        nongovernmental organizations, international organizations, or 
        multilateral financial institutions, is authorized--
                    (A) to grant loans;
                    (B) to set aside funds for use in the 
                implementation of financing mechanisms under subsection 
                (a);
                    (C) to use a financial intermediary to implement a 
                pay-for-performance financing mechanism, subject to the 
                eligibility requirements set forth under subsection 
                (c);
                    (D) to issue sovereign level guarantees; and
                    (E) to make equity investments.
    (c) Eligibility for Participation.--In order to participate in the 
pay-for-performance program, partner countries shall be required by the 
United States Government to commit to--
            (1) fully benchmarked plans to increase nominal and per 
        capita health spending; and
            (2) fully developed and budgeted maternal and child 
        survival plans.
    (d) Project Qualification.--In order to have a project qualify 
under subsection (c), the partner country or its designated 
implementing partner must produce--
            (1) specific outcome goals for the project;
            (2) a description of each intervention and projected 
        outcome for the project;
            (3) rigorous evidence demonstrating that the interventions 
        can be expected to produce the projected outcomes;
            (4) an estimate of projected government costs and savings 
        to conduct the project;
            (5) a description of how the outcomes are monetized and 
        secured against fixed costs;
            (6) a description of the target population or populations 
        that will be served by the project;
            (7) a description of the expected social benefits to 
        participants who receive the interventions, as well as others 
        who may be impacted;
            (8) the metrics that will be used to determine whether the 
        outcomes have been achieved and the methods to be used to 
        measure those metrics; and
            (9) a plan for sustainability of efforts.
    (e) Establishment of Development Impact Partnership.--The United 
States Government shall support the creation of a development impact 
partnership to act as a financial intermediary and facilitate the 
financing mechanism established under this section. The partnership 
shall be designed to allow for the incorporation of private sources and 
other nongovernmental sources of capital to leverage United States 
Government investments, foster public-private partnerships, and engage 
private sector actors in developing countries to achieve measurable 
progress towards the strategy established under section 5.

SEC. 9. AUTHORIZATION OF FUNDING.

    (a) Authorization.--There are authorized to be appropriated such 
sums as may be necessary to carry out the maternal and child strategy, 
financing framework, and Development Impact Partnership.
    (b) Application.--Federal funds appropriated to carry out 
activities under this act shall be subject to all applicable 
restrictions under Federal law.
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