[Congressional Bills 117th Congress]
[From the U.S. Government Publishing Office]
[S. 1451 Introduced in Senate (IS)]

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117th CONGRESS
  1st Session
                                S. 1451

 To amend the Foreign Assistance Act of 1961 to implement policies to 
     end preventable maternal, newborn, and child deaths globally.


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

                             April 29, 2021

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 amend the Foreign Assistance Act of 1961 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 
2021''.

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. 138. 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 designated 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 Bureau for Global Health, missions, or other 
        operating units of the United States Agency for International 
        Development.
            ``(5) Most vulnerable populations.--The term `most 
        vulnerable populations' includes adolescents, populations in 
        conflict-affected or fragile areas, indigenous populations, 
        religious minorities, individuals with disabilities, and the 
        poorest quintile in urban and remote locations.
            ``(6) Priority countries.--The term `priority countries' 
        means 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.
            ``(7) 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.
    ``(c) Statement of Policy.--It is the policy of the United States, 
in partnership with priority countries and relevant partner entities, 
to establish and implement a coordinated, integrated, and comprehensive 
strategy to end preventable child and maternal deaths and ensure 
healthy and productive lives by--
            ``(1) focusing on bringing to scale the highest-impact, 
        evidence-based interventions that address the leading causes of 
        maternal, newborn, and child mortality in each priority 
        country;
            ``(2) ensuring equitable access to essential health 
        services for the most vulnerable populations, with a focus on 
        country and community ownership;
            ``(3) designing, implementing, monitoring, and evaluating 
        programs in a manner that enhances transparency and 
        accountability, increases sustainability, and improves outcomes 
        in priority countries; and
            ``(4) 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 1 year after the date of 
        the enactment of the Reach Every Mother and Child Act of 2021, 
        the President should establish and implement a comprehensive 5-
        year strategy (in this subsection referred to as the 
        `strategy') 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) Leadership.--The Administrator, in coordination with 
        priority countries and relevant partner entities, shall lead 
        the establishment and implementation of the strategy.
            ``(3) Elements.--The strategy should--
                    ``(A) identify priority countries in which the 
                United States Agency for International Development will 
                implement international maternal and child health and 
                nutrition programs to reduce maternal, newborn, and 
                child mortality and improve health outcomes;
                    ``(B) with respect to each priority country, 
                identify the most significant barriers to maternal, 
                newborn, and child survival and establish outcome-based 
                targets from which progress toward addressing those 
                barriers through international maternal and child 
                health and nutrition programs can be tracked;
                    ``(C) in coordination with relevant partner 
                entities, outline how the United States Agency for 
                International Development will implement the highest-
                impact, evidence-based interventions for reducing 
                maternal, newborn, and child mortality and expand 
                access to quality services through community-based 
                approaches to achieve the outcome-based targets 
                established under subparagraph (B);
                    ``(D) promote investments in community-based 
                activities that empower women, support voluntarism, and 
                provide respectful maternity care;
                    ``(E) describe how the most vulnerable populations 
                in each priority country will be targeted and reached 
                with highest-impact, evidence-based interventions to 
                reduce maternal, newborn, and child mortality;
                    ``(F) use United States Government strategies and 
                frameworks relevant to improving maternal, newborn, and 
                child health;
                    ``(G) address backsliding on access to and demand 
                for essential health services and other key challenges 
                affecting maternal, newborn, and child survival caused 
                by the COVID-19 pandemic;
                    ``(H) include development and scale-up of new 
                technologies and approaches, including those supported 
                by public-private partnerships, for research and 
                innovation;
                    ``(I) promote coordination and efficiency within 
                and among 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, 
                the President's Malaria Initiative, and the United 
                States International Development Finance Corporation;
                    ``(J) project general levels of resources needed to 
                achieve the objectives stated in the strategy; and
                    ``(K) support the transition to domestic 
                sustainably financed health systems, emphasizing 
                partnerships that seek to ensure affordability, 
                accessibility, quality, and delivery of health services 
                in an equitable and sustainable manner.
            ``(4) Development of strategy.--
                    ``(A) Consultation by administrator.--The 
                Administrator shall consult with missions of the United 
                States Agency for International Development in priority 
                countries, civil society, and implementing partner 
                organizations to inform the development of the 
                strategy.
                    ``(B) Local consultation; summary.--The missions of 
                the United States Agency for International Development 
                in priority countries shall consult with relevant 
                partner entities and submit to the Coordinator a 
                summary of such consultations to inform the development 
                of the strategy.
    ``(e) Establishment of Child and Maternal Survival Coordinator.--
            ``(1) In general.--The President should designate an 
        individual, selected from among employees of the United States 
        Agency for International Development serving in career or 
        noncareer positions 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.
            ``(2) Duties.--The Coordinator should--
                    ``(A) oversee--
                            ``(i) the strategy established under 
                        subsection (d)(1); and
                            ``(ii) international maternal and child 
                        health and nutrition programs, including by 
                        representing the United States at international 
                        and multilateral maternal and child health and 
                        nutrition organizations;
                    ``(B) have primary responsibility for the oversight 
                and coordination of all resources and international 
                activities of the United States Government appropriated 
                or used for international maternal and child health and 
                nutrition programs, as determined appropriate by the 
                Administrator;
                    ``(C) 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;
                    ``(D) lead implementation and revision of the 
                strategy established under subsection (d)(1) beginning 
                5 years after the date on which the strategy is 
                released;
                    ``(E) coordinate with relevant executive branch 
                agencies, priority countries, and relevant partner 
                entities as appropriate, to carry out the strategy 
                established under subsection (d)(1) and to align 
                current and future investments with high-impact, 
                evidence-based interventions to save lives;
                    ``(F) 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
                    ``(G) 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 for carrying out responsibilities and 
        duties under this section.
    ``(f) Authority To Assist in Implementation of the Strategy.--
            ``(1) In general.--The President may provide assistance to 
        implement the strategy established under subsection (d)(1).
            ``(2) Focus on impact.--
                    ``(A) Targets for implementation required.--
                Consistent with the guidelines established under 
                section 3 of the Foreign Aid Transparency and 
                Accountability Act of 2016 (22 U.S.C. 2394c note; 
                Public Law 114-191), the Administrator shall require 
                United States Agency for International Development 
                grants, contracts, and cooperative agreements, for the 
                purposes of the strategy established under subsection 
                (d)(1), to include targets for implementation of high-
                impact, evidence-based interventions and strengthening 
                health systems, as appropriate, including baseline 
                measurements from which to quantify progress.
                    ``(B) Exception.--In exceptional circumstances for 
                which the Administrator determines that the inclusion 
                of targets described in subparagraph (A) is not 
                reasonable or practicable for a grant, contract, or 
                cooperative agreement, the grant, contract, or 
                cooperative agreement, as the case may be, should 
                include an explanation of the omission and explicitly 
                state how measurable impact will be targeted and 
                tracked.
    ``(g) Annual Reports.--
            ``(1) Reports required.--Not later than 1 year after the 
        date of the enactment of the Reach Every Mother and Child Act 
        of 2021, and annually thereafter until December 31, 2030, the 
        President shall submit to the appropriate congressional 
        committees a report on progress made to achieve the goals set 
        forth in the strategy established under subsection (d)(1).
            ``(2) Information included in reports.--Each report 
        required by paragraph (1) should include the following:
                    ``(A) Indicators used by the United States Agency 
                for International Development to monitor and evaluate 
                progress of international maternal and child health and 
                nutrition programs toward ending preventable child and 
                maternal deaths in each priority county, such as the 
                standard foreign assistance indicators of the 
                Department of State and such other indicators as the 
                Coordinator considers relevant.
                    ``(B) Estimates of maternal, newborn, and child 
                deaths averted as a result of international maternal 
                and child health and nutrition programs.
                    ``(C) Data pertaining to populations served by 
                international maternal and child health and nutrition 
                programs, disaggregated by gender, age, and wealth 
                quintile.
                    ``(D) A description of targets for coverage of 
                interventions and services in international maternal 
                and child health and nutrition programs and progress 
                toward meeting those targets.
                    ``(E) Reporting on each aspect of the strategy 
                established under subsection (d)(1).
                    ``(F) Information on funding for international 
                maternal and child health and nutrition programs 
                overall and for each priority country, including 
                funding that has been planned, appropriated, obligated, 
                or expended for the fiscal year in which the briefing 
                is conducted and the previous 5 fiscal years.
            ``(3) Public availability.--The President shall make each 
        report required by paragraph (1) publicly available.
    ``(h) Use of Funds.--Funds appropriated or otherwise made available 
to carry out activities under this section shall be subject to all 
applicable restrictions under Federal law.''.
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