[Congressional Bills 116th Congress]
[From the U.S. Government Publishing Office]
[S. 1766 Introduced in Senate (IS)]
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116th CONGRESS
1st Session
S. 1766
To implement policies to end preventable maternal, newborn, and child
deaths globally.
_______________________________________________________________________
IN THE SENATE OF THE UNITED STATES
June 10, 2019
Ms. Collins (for herself, Mr. Coons, Mr. Roberts, Ms. Duckworth, Mr.
Sullivan, Mr. Van Hollen, Mrs. Capito, Mr. Markey, Mr. Isakson, Mr.
Merkley, Mr. Moran, Mr. Cardin, Mr. Cornyn, Ms. Rosen, Mr. Young, Ms.
Stabenow, Mr. Enzi, Mr. Wyden, Mr. Cramer, Mr. Murphy, Mr. Rubio, and
Mr. Reed) 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
2019''.
SEC. 2. ASSISTANCE TO END PREVENTABLE MATERNAL, NEWBORN, AND CHILD
DEATHS GLOBALLY.
The Foreign Assistance Act of 1961 (22 U.S.C. 2151 et seq.) is
amended by adding at the end of chapter I of part I the following new
section:
``SEC. 137. ASSISTANCE TO END PREVENTABLE MATERNAL, NEWBORN, AND CHILD
DEATHS GLOBALLY.
``(a) Purpose.--The purpose of this section is to implement a
strategic approach for providing foreign assistance in order to end
preventable child and maternal deaths globally by 2030.
``(b) Definitions.--In this section:
``(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 Child
and Maternal Survival Coordinator established under subsection
(e).
``(4) International maternal and child health and nutrition
programs.--The term `international maternal and child health
and nutrition programs' means all programs carried out using
funds appropriated or otherwise made available for
international maternal and child health and nutrition that are
managed by the United States Agency for International
Development Bureau of Global Health.
``(5) Relevant partner entities.--The term `relevant
partner entities' means each of the following:
``(A) The governments of other donor countries.
``(B) International financial institutions.
``(C) Nongovernmental organizations.
``(D) Faith-based organizations.
``(E) Professional organizations.
``(F) The private sector.
``(G) Multilateral organizations.
``(H) Local and international civil society groups.
``(I) Local health workers.
``(J) International organizations.
``(6) Target countries.--The term `target countries' means
specific countries that have the greatest need and highest
burden of child and maternal deaths, taking into consideration
countries that--
``(A) have high-need communities in fragile states
or conflict-affected states;
``(B) are low- or middle-income countries; or
``(C) are located in regions with weak health
systems.
``(c) Statement of Policy.--It is the policy of the United States,
in partnership with target countries and relevant partner entities, to
establish and implement a coordinated, integrated, and comprehensive
strategy to combat the leading causes of maternal, newborn, and child
mortality globally and ensure healthy and productive lives by--
``(1) focusing on bringing to scale, specific to each
country's needs, the highest impact, evidence-based
interventions, including for the most vulnerable populations,
with a focus on country and community ownership;
``(2) designing, implementing, monitoring, and evaluating
programs in a way that enhances transparency and
accountability, increases sustainability, and improves outcomes
in target countries; and
``(3) supporting the research, development, and
introduction of innovative tools and approaches to accelerate
progress toward ending preventable child and maternal deaths.
``(d) Strategy.--
``(1) In general.--Not later than one year after the date
of the enactment of the Reach Every Mother and Child Act of
2019, the President shall establish and implement a
comprehensive five-year, whole-of-government strategy, together
with target countries and donors, to contribute toward the
global goal of ending preventable child and maternal deaths by
2030 as a foundation for ensuring healthy and productive lives.
``(2) Elements.--The strategy established under paragraph
(1) shall--
``(A) 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;
``(B) utilize United States Government strategies
and frameworks relevant to ending preventable child and
maternal deaths, including specific objectives,
programs, and approaches to achieve the highest-impact,
evidence-based interventions to address the leading
causes of death, particularly among the most vulnerable
populations, of--
``(i) women related to pregnancy,
childbirth, and post-delivery;
``(ii) newborns in their first 28 days; and
``(iii) infants and children under the age
of five years old;
``(C) include development and scale up of new
technologies and approaches, including those supported
by public-private partnerships, for research and
innovation;
``(D) promote coordination and efficiency 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;
``(E) project general levels of resources needed to
achieve the strategy's stated objectives;
``(F) identify strategies for leveraging resources
in new and innovative ways;
``(G) align with country- and community-driven
maternal, newborn, and child health and survival plans
and improve coordination with foreign governments and
international organizations;
``(H) outline consultations with relevant partner
entities as appropriate;
``(I) implement results-based contracting (such as
pay-for-success) and financial and operational risk
reduction;
``(J) promote a shift towards investments that
support inclusive and sustainable business models; and
``(K) support the transition to domestic
sustainably financed health systems.
``(3) Initial strategy.--For the purposes of this section,
a strategy meeting the criteria described in paragraph (2) that
is in effect as of the date of enactment of this section may be
deemed to fulfill the establishment requirement in paragraph
(1).
``(e) Establishment of Child and Maternal Survival Coordinator.--
``(1) In general.--The President 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
Child and Maternal Survival Coordinator. The Coordinator shall
be responsible for--
``(A) overseeing the strategy established under
subsection (d); and
``(B) international maternal and child health and
nutrition programs.
``(2) Duties.--The Coordinator shall--
``(A) have the primary responsibility for the
oversight and coordination of all resources and
international activities, as determined appropriate by
the Administrator of the United States Agency for
International Development, of the United States
Government appropriated or used for international
maternal and child health and nutrition programs;
``(B) direct the budget, planning, and staffing to
implement international maternal and child health and
nutrition programs for the purpose of ending
preventable child and maternal deaths;
``(C) lead implementation and revision, not less
frequently than once every 5 years, of the strategy
established under subsection (d)(1);
``(D) coordinate with relevant executive branch
agencies, target countries, and relevant partner
entities as appropriate, to carry out the strategy
established under section 5(a) and to align current and
future investments with high-impact, evidence-based
interventions to save lives;
``(E) provide guidance on the design and oversight
of grants, contracts, and cooperative agreements with
nongovernmental organizations (including community,
faith-based, and civil society organizations) and
private sector entities for the purpose of carrying out
the strategy established under subsection (d)(1); and
``(F) report directly to the Administrator
regarding implementation of the strategy established
under subsection (d)(1).
``(3) Restriction on additional or supplemental
compensation.--The Coordinator shall receive no additional or
supplemental compensation as a result of carrying out
responsibilities and duties under this section.
``(f) Authority To Assist in Implementation of the Strategy.--
``(1) In general.--The President shall provide assistance
to implement the strategy established under subsection (d)(1).
``(2) Focus on impact.--
``(A) Targets for increased implementation
required.--Consistent with the requirements for foreign
assistance programs included in the Foreign Aid
Transparency and Accountability Act of 2016 (Public Law
114-119), USAID grants, contracts, and cooperative
agreements for the purposes of the strategy established
under subsection (d)(1) shall be required to include
targets for increased implementation of high-impact,
evidence-based interventions and strengthening health
systems, as appropriate, including the establishment of
baseline measurements from which to quantify progress.
``(B) Exception.--In exceptional circumstances
where USAID determines that inclusion of coverage
targets or baseline measures are not reasonable or
practicable for the grant, contract, or cooperative
agreement, the funding mechanism shall include an
explanation of the omission and explicitly state how
measurable impact will be targeted and tracked.
``(g) Reports.--
``(1) Report required.--Not later than one year after the
date of the enactment of this section, and annually thereafter
for 5 additional years, the President shall submit to the
appropriate congressional committees a report on progress made
to achieve the strategy established under subsection (d)(1) as
well as progress toward the goal to end preventable child and
maternal deaths globally. The report shall be made publicly
available.
``(2) Information included in report.--The report required
under paragraph (1) shall include the following elements:
``(A) Indicators of progress made by United States
Government programs carried out under international
maternal and child health and nutrition programs for
the purposes of improving maternal, newborn, and child
health and survival, particularly among the most
vulnerable populations, in each target country and
overall, including--
``(i) maternal mortality ratio per 100,000
live births and under-5 mortality ratio per
1,000 live births;
``(ii) number of maternal, newborn, and
child deaths averted;
``(iii) percentage of births attended by
skilled health personnel;
``(iv) an analysis of gaps in the health
workforce required to end preventable child and
maternal deaths, including an analysis of
health workforce density (number of certified
health workers, including community-based
health workers, per population);
``(v) a description of the measured or
estimated impact on maternal, newborn, and
child survival of each ongoing program or
project;
``(vi) progress towards achieving the goal
to save 15,000,000 children's lives and 600,000
women's lives, and any subsequent goals
established under the strategy required under
subsection (d); and
``(vii) any other targets identified by the
Coordinator as essential to meeting the goals
of the strategy for ending preventable child
and maternal deaths.
``(B) Assessments of progress made toward achieving
the targets set forth under subparagraph (A).
``(C) A description of how the interventions or
programs are designed to--
``(i) increase activities in target
countries;
``(ii) reach underserved, marginalized,
vulnerable, under nourished or malnourished,
and impoverished populations;
``(iii) address causes of maternal,
newborn, and child mortality with innovative
efforts and interventions posed to go to scale;
``(iv) invest in activities that empower
women, support voluntarism, and provide
respectful maternity care;
``(v) improve transparency and
accountability at all levels and include common
metrics for tracking progress;
``(vi) ensure that high-impact, evidence-
based interventions are prioritized; and
``(vii) expand access to quality services
through community-based approaches and include
community accountability measures.
``(D) Reporting on each aspect of the strategy
established under subsection (d)(1), including--
``(i) multi-sectoral approaches, specific
strategies, and programming utilizing high-
impact, evidence-based interventions to address
the leading causes of preventable child and
maternal deaths;
``(ii) activities to develop and scale up
new technologies and approaches, including
those identified by public-private
partnerships, for research and innovation;
``(iii) coordination with United States
agencies, foreign governments, nongovernmental
organizations, and international organizations;
``(iv) methods used to leverage new
financial and other public and private
resources in innovative ways; and
``(v) best practices identified by the
executive branch.
``(E) Reporting on grants, contracts, and
cooperative agreements awarded, including--
``(i) a comprehensive list of USAID grants,
contracts, and cooperative agreements awarded
in implementation of the strategy established
under subsection (d)(1); and
``(ii) a description of--
``(I) the targets for coverage of
interventions or services and the
baseline against which they are
measured and the status of progress in
meeting the targets; or
``(II) in the case of exceptional
circumstances where USAID determines
that inclusion of targets or baseline
measurements is not reasonable or
practicable, an explanation of how the
impact of the grant, contract,
agreement, or resulting program is
being measured.
``(F) Reporting on the innovative public-private
financing tools, including an analysis of the
feasibility and potential effectiveness of new
financing tools that could be used to fund efforts to
end preventable child and maternal deaths globally.
``(h) Authorization of Appropriations.--
``(1) Authorization.--For each of fiscal years 2020 and
2021, there is authorized to be appropriated to the Secretary
of State and the Administrator of the United States Agency for
International Development to carry out this section--
``(A) $545,000,000 for bilateral maternal and child
health;
``(B) $290,000,000 for Gavi, the Vaccine Alliance;
and
``(C) $145,000,000 for nutrition.
``(2) Application.--Funds appropriated or otherwise made
available to carry out activities under this section shall be
subject to all applicable restrictions under Federal law.
``(3) Expiration of funds.--Amounts appropriated or
otherwise made available to carry out activities under this
section shall remain available for obligation for a period of 5
years.''.
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