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<dc:title>114 S2956 IS: Global Malnutrition Prevention and Treatment Act of 2021</dc:title>
<dc:publisher>U.S. Senate</dc:publisher>
<dc:date>2021-10-07</dc:date>
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<dc:language>EN</dc:language>
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<distribution-code display="yes">II</distribution-code><congress>117th CONGRESS</congress><session>1st Session</session><legis-num>S. 2956</legis-num><current-chamber>IN THE SENATE OF THE UNITED STATES</current-chamber><action><action-date date="20211007">October 7, 2021</action-date><action-desc><sponsor name-id="S337">Mr. Coons</sponsor> (for himself, <cosponsor name-id="S318">Mr. Wicker</cosponsor>, <cosponsor name-id="S362">Mr. Kaine</cosponsor>, and <cosponsor name-id="S343">Mr. Boozman</cosponsor>) introduced the following bill; which was read twice and referred to the <committee-name committee-id="SSFR00">Committee on Foreign Relations</committee-name></action-desc></action><legis-type>A BILL</legis-type><official-title>To advance targeted, high-impact, and evidence-based interventions for the prevention and treatment of global malnutrition, to improve the coordination of such programs, and for other purposes.</official-title></form><legis-body><section id="S1" section-type="section-one"><enum>1.</enum><header>Short title</header><text display-inline="no-display-inline">This Act may be cited as the <quote><short-title>Global Malnutrition Prevention and Treatment Act of 2021</short-title></quote>.</text></section><section id="id07fabdf78f82482e958e989e0ebf1fcc"><enum>2.</enum><header>Nutrition programs</header><subsection id="idf3f3568a130448b897a3659b7748b998"><enum>(a)</enum><header>In general</header><text>The Administrator of the United States Agency for International Development, in coordination with relevant Federal departments and agencies, is authorized and encouraged to scale up the prevention and treatment of global malnutrition, including by supporting efforts—</text><paragraph id="id84acd62bef7b43ce90c7c9b001fa3a7f"><enum>(1)</enum><text>to target high-impact and evidence-based resources and nutrition interventions to support the most vulnerable populations, including children younger than 5 years of age and pregnant and lactating women, susceptible to severe malnutrition, including both stunting and wasting;</text></paragraph><paragraph id="idf8819dadf8aa4981a81997beba73b017"><enum>(2)</enum><text>to increase coverage, particularly within priority countries, of high-impact and evidence-based nutrition interventions that include coordinated deployment of prenatal vitamins, breastfeeding support, vitamin A supplementation, emergency therapeutic food, and other evidence-based interventions as appropriate;</text></paragraph><paragraph id="idba33f0b7fbcd4df98080bb68484c04bf"><enum>(3)</enum><text>to increase the use of context and country-appropriate fortification of staples and condiments with essential nutrients;</text></paragraph><paragraph id="ide59b7fa4b3574e039a101c3e7940eddf"><enum>(4)</enum><text>to advance evidence-based programs and interventions carried out using data-driven approaches, best practices, and targeted to country-specific contexts and needs;</text></paragraph><paragraph id="idfd667297b047401b9c7dbd65d292ea67"><enum>(5)</enum><text>to support the development of country-specific policies to prevent and treat malnutrition;</text></paragraph><paragraph id="id8164f99eec094bd9a7b2365a4ed3ca32"><enum>(6)</enum><text>to leverage investments to strengthen primary health systems and support community health workers in order to advance improved nutrition outcomes; and</text></paragraph><paragraph id="id1545e5c35d2749fe971c1f3506521dd5"><enum>(7)</enum><text>to ensure rigorous monitoring and evaluation of all nutrition programs and interventions.</text></paragraph></subsection><subsection id="id2a0bc9b571b14fd1ab5ebabf5a507171"><enum>(b)</enum><header>Coordination</header><text>The Administrator of the United States Agency for International Development, in coordination with relevant Federal departments and agencies, should coordinate with bilateral and multilateral donors, partner country governments, United Nations agencies, civil society, nongovernmental organizations, including faith-based organizations, and the private sector to scale up efforts to prevent and treat global malnutrition, including by—</text><paragraph id="idc3a96976fb984d67a50ed4361311eacb"><enum>(1)</enum><text>building the capacity of local and community-based organizations and partner country governments to expand coverage and ensure sustainability of nutrition interventions;</text></paragraph><paragraph id="id0d56a621293848858fc72ab2d7e1b7e5"><enum>(2)</enum><text>expanding research and innovation to identify and scale effective and evidence-based nutrition interventions based on country-specific contexts;</text></paragraph><paragraph id="ide95a2c99741c48a0a5412ee67ff932f0"><enum>(3)</enum><text>improving the coordination of nutrition interventions, including within the United Nations;</text></paragraph><paragraph id="idaa261b1fd38f41c88337091f62a0acb0"><enum>(4)</enum><text>leveraging additional resources and ensuring appropriate burden-sharing to support nutrition interventions in priority countries;</text></paragraph><paragraph id="id13bcc9c25b4d4e76aa6f4a4d36b3d049"><enum>(5)</enum><text>expanding domestic resource mobilization and domestic financing for nutrition interventions; and</text></paragraph><paragraph id="id1c00594c616c4296a2cea75b516d16db"><enum>(6)</enum><text>encouraging investment into innovative and multistakeholder finance partnerships.</text></paragraph></subsection></section><section id="id7326cbdc2dbb42cf8faa5c4e021e9c17"><enum>3.</enum><header>Priority countries</header><subsection id="id2fd3646d6d5147d0a94168b4d5951c5b"><enum>(a)</enum><header>Designation</header><text>The Administrator, in coordination with the Nutrition Leadership Council, shall—</text><paragraph id="idDE981D6CF8EE4255A35F0C7B6816C315"><enum>(1)</enum><text>designate certain countries as <quote>priority countries</quote> for the purposes of prioritizing programs to prevent and treat malnutrition; and </text></paragraph><paragraph id="idEB562B8B0AC24F0C844E2EDE5D60F6E1"><enum>(2)</enum><text>not later than 5 years after the date of the enactment of this Act, review and update such designations based on the criteria described in subsection (b).</text></paragraph></subsection><subsection id="idb550ede2f097465da69b9caf873a4640"><enum>(b)</enum><header>Criteria</header><text>In selecting priority countries under subsection (a), the Administrator should consider—</text><paragraph id="id7a5e7552e7a3459b8f7b2ca23ea8ff93"><enum>(1)</enum><text>the prevalence of severe malnutrition among children younger than 5 years of age and pregnant and lactating women;</text></paragraph><paragraph id="id509c1b31ca69449093750b88fcc820d8"><enum>(2)</enum><text>the presence of high-need, underserved, marginalized, vulnerable, or impoverished communities;</text></paragraph><paragraph id="id4a6ff7db58c1467bafde27fb9adafc14"><enum>(3)</enum><text>the enabling environment for improved nutrition, including the presence of national nutrition plans and the demonstration of strong political commitment; and</text></paragraph><paragraph id="id58bf036ab0d84d36bce67255e024be1a"><enum>(4)</enum><text>other appropriate factors.</text></paragraph></subsection><subsection id="id17682c6fe02b44278e6f8bf459a5675f"><enum>(c)</enum><header>Sense of Congress</header><text>It is the sense of Congress that the Administrator should continue to undertake nutrition interventions in countries that are not selected as priority countries, particularly if opportunities are identified to advance multi-sectoral development programming and to integrate efforts to prevent and treat global malnutrition with other priority areas and program objectives.</text></subsection></section><section id="id87e8474f6ceb41cc9f07f94fc1fe463b"><enum>4.</enum><header>Coordination</header><subsection id="idda0bf9e374b74d42ad3be05218d20ca2"><enum>(a)</enum><header>Nutrition Leadership Council</header><text>There is established at the United States Agency for International Development (referred to in this section as <quote>USAID</quote>), the Nutrition Leadership Council (referred to in this section as the <quote>Council</quote>), which shall coordinate efforts by USAID to prevent and treat malnutrition globally.</text></subsection><subsection id="id8999415473cd4ef58a73f8591411be84"><enum>(b)</enum><header>Duties</header><text>The Council shall—</text><paragraph id="idf4a1b144e5e34b368463d09a64ef2dbc"><enum>(1)</enum><text>advance efforts by USAID to prevent and treat malnutrition globally;</text></paragraph><paragraph id="idae2abfc04bdd45348b85c44da18a24ea"><enum>(2)</enum><text>ensure that nutrition interventions, particularly within priority countries, are carried out in close coordination with and aligned with existing United States Government and USAID strategies, including—</text><subparagraph id="idf3eda1a18e9e494882ef101c4c430fee"><enum>(A)</enum><text>the Senator Paul Simon Water for the World Act of 2014 (<external-xref legal-doc="public-law" parsable-cite="pl/113/289">Public Law 113–289</external-xref>); </text></subparagraph><subparagraph id="ide2587de518874af1b1ccc67d7cb6fc3e"><enum>(B)</enum><text>the Global Food Security Act of 2016 (<external-xref legal-doc="usc" parsable-cite="usc/22/9301">22 U.S.C. 9301 et seq.</external-xref>);</text></subparagraph><subparagraph id="idb7ac14a7fe6d42a6b298237718e328a9"><enum>(C)</enum><text>the Global Fragility Act of 2019 (<external-xref legal-doc="usc" parsable-cite="usc/22/9801">22 U.S.C. 9801 et seq.</external-xref>); and</text></subparagraph><subparagraph id="id92114cc18a8342ebbcb9dba7c06e8740"><enum>(D)</enum><text>the Global Child Thrive Act of 2020 (subtitle I of title XII of division A of <external-xref legal-doc="public-law" parsable-cite="pl/116/283">Public Law 116–283</external-xref>); and </text></subparagraph></paragraph><paragraph id="id2fd3a135348647a99b1348266f12ba33"><enum>(3)</enum><text>ensure that nutrition programs and interventions are coordinated with nutrition programs carried out by other relevant Federal departments and agencies.</text></paragraph></subsection><subsection id="id0176524cddb84d4d8be702586e32ea1e"><enum>(c)</enum><header>Membership</header><text>The Council shall include representatives of—</text><paragraph id="id05ca01ec8b714e09a3b8a677306c5e17"><enum>(1)</enum><text>the Bureau for Global Health;</text></paragraph><paragraph id="id7c814b38e3d34feabf6d2e3803a17a45"><enum>(2)</enum><text>the Bureau for Resilience and Food Security;</text></paragraph><paragraph id="id1e1df0245c864a9c831365152c25dccf"><enum>(3)</enum><text>the Bureau for Humanitarian Assistance; and</text></paragraph><paragraph id="id7d947245436645ddacd00135a3702668"><enum>(4)</enum><text>other appropriate USAID bureaus and offices.</text></paragraph></subsection><subsection id="id1a13cca73a764c55879cc1fb57c3fb4e"><enum>(d)</enum><header>Interagency efforts</header><text>In carrying out the activities described in section 2, the Administrator, in coordination with relevant Federal departments and agencies, shall seek to leverage additional private sector resources to prevent and treat malnutrition in priority countries by—</text><paragraph id="id920afe4a18374d31bcbbe1bcc3b86720"><enum>(1)</enum><text>increasing cooperation between USAID, the Millennium Challenge Corporation, the United States International Development Finance Corporation, and other relevant Federal departments and agencies to better leverage the full spectrum of grants, technical assistance, debt, equity, loan guaranty tools, and public-private partnerships to prevent and treat global malnutrition;</text></paragraph><paragraph id="ide2692e600d1a4520ad0be1ea18fbcc3e"><enum>(2)</enum><text>utilizing the Administrator’s role as Development Finance Corporation Vice Chair to consider opportunities within the Development Finance Corporation’s development impact framework that support improved nutrition outcomes; and</text></paragraph><paragraph id="id35c25d147d504a97be03e1ce460acc4b"><enum>(3)</enum><text>exploring opportunities to advance burden-sharing in nutrition-related assistance.</text></paragraph></subsection></section><section id="id5b254cfb48dd477aad86e14a6f8937e2"><enum>5.</enum><header>Implementation plan</header><subsection id="idb62d335b7cd840e282cf69bd1c71071e"><enum>(a)</enum><header>In general</header><text>Not later than 260 days after the date of the enactment of this Act, the Administrator, in coordination with other relevant Federal departments and agencies, shall develop and submit to the appropriate congressional committees an implementation plan to prevent and treat global malnutrition and carry out the activities authorized under section 2. </text></subsection><subsection id="id2C2BC908E4B14E4BA168F7E672B59336"><enum>(b)</enum><header>Contents</header><text>The implementation plan required under subsection (a) shall—</text><paragraph id="id65e34af9e4094a28bb8e93f54a8f76c2"><enum>(1)</enum><text>establish specific and measurable goals, objectives, and performance metrics towards prevention and treatment of global malnutrition, including clear benchmarks and intended timelines for achieving such goals and objectives;</text></paragraph><paragraph id="id9e091235b22448c9b0c0a9b5f4e75027"><enum>(2)</enum><text>establish baseline measurements and time-bound targets for increasing coverage of key nutrition interventions in priority countries, which may include scaling up to—</text><subparagraph id="id5e42dab6350d44129e9649684c41ecfb"><enum>(A)</enum><text>80-percent coverage for—</text><clause id="idA779F88C8EDE4319AFE500827AD02C3B"><enum>(i)</enum><text>vitamin A (to be measured by the proportion of children 6 to 59 months old receiving 2 high-dose vitamin A supplements in a given year);</text></clause><clause id="id3D56345890164FE3BFC049A932ED542E"><enum>(ii)</enum><text>prenatal vitamins (measured by the proportion of pregnant women who received multiple micronutrient supplementation daily); and </text></clause><clause id="id8168B42738A64608B330929FB494FC19"><enum>(iii)</enum><text>breastfeeding (as measured by proportion of mothers of children between 0 and 5 months of age reached by promotion of breastfeeding activities); and</text></clause></subparagraph><subparagraph id="ide844228c870e40c0bbbf6ca99e185316"><enum>(B)</enum><text>50-percent coverage for treatment of wasting (as measured by the proportion of children 6 to 59 months with severe acute malnutrition receiving therapeutic feeding treatment);</text></subparagraph></paragraph><paragraph id="idc56d9f5607244228a80bb52f13fbb299"><enum>(3)</enum><text>require monitoring and evaluation plans for all nutrition programs and activities, as appropriate;</text></paragraph><paragraph id="id5955a9596c7c42309adf6cea9e71e268"><enum>(4)</enum><text>in countries that were selected as priority countries, ensure that nutrition is adequately addressed within the Country Development Cooperation Strategy to the extent practicable and identify opportunities to expand efforts to prevent and treat malnutrition, including through leveraging existing health and development programs and other ongoing activities; and</text></paragraph><paragraph id="id555eb657f5ad4e6195085ba718ca6602"><enum>(5)</enum><text>require all USAID grants, contracts, and cooperative agreements for the purposes of the treatment or prevention of severe malnutrition to include targets for increased coverage of high-impact nutrition interventions, including the establishment of baseline measurements from which to quantify progress.</text></paragraph></subsection><subsection id="idb1733a4739ed48268a42ea55c08989cf"><enum>(c)</enum><header>Stakeholder consultation</header><text>The implementation plan required under this section shall be developed in consultation with, as appropriate, representatives of nongovernmental organizations, including faith-based organizations, civil society groups, multilateral organizations and donors, relevant private, academic, and philanthropic entities, and the appropriate congressional committees.</text></subsection></section><section id="idefd9695a993a4895b69a4434e1fb020e"><enum>6.</enum><header>Reporting requirements</header><subsection id="iddf763a070d9e4f4fab3fee3a218d02a5"><enum>(a)</enum><header>Annual report</header><text>Not later than 1 year after the date of the enactment of this Act, and annually thereafter for 5 additional years, the Administrator shall submit a report to the appropriate congressional committees that describes the progress made towards preventing and treating malnutrition, including—</text><paragraph id="id7d19ace60e6f44beb7dcc2a047707a9b"><enum>(1)</enum><text>a summary of the progress made towards achieving the specific and measurable goals, objectives, and performance metrics towards ending global malnutrition identified as required under section 5(b)(1);</text></paragraph><paragraph id="id5d26b9112f5f4a0ab9d258aed0049163"><enum>(2)</enum><text>in countries identified as priority countries—</text><subparagraph id="idc276246273294aec8d77f94a149070df"><enum>(A)</enum><text>a detailed summary of nutrition programs and activities in the previous fiscal year, including—</text><clause id="id570AB72808FB4538A795F1440797101E"><enum>(i)</enum><text>a breakdown of the countries to which nutrition resources have been allocated; and </text></clause><clause id="idEAC52C6AC43349E59BDD7AAF78CE3763"><enum>(ii)</enum><text>the estimated number of people reached through nutrition interventions; and</text></clause></subparagraph><subparagraph id="ide136135ca91246ec977b90d5cdcd562a"><enum>(B)</enum><text>an assessment of the coordination of nutrition programs with other health and development programs and priorities; </text></subparagraph></paragraph><paragraph id="id7de866b078b8427c89178db53fdf598d"><enum>(3)</enum><text>a summary of efforts to expand research and innovation to development and scale up new tools to prevent and treat global malnutrition;</text></paragraph><paragraph id="id18f7e9f9bbd14cde9bbc0fe3680bda1a"><enum>(4)</enum><text>an assessment of the collaboration and coordination of USAID nutrition efforts with the United Nations agencies, the World Bank, other donor governments, host country governments, civil society, the private sector, and other efforts, as appropriate;</text></paragraph><paragraph id="id3d3670516bbf4aa6985860557add5b4c"><enum>(5)</enum><text>a description of other donor and host country financial commitments and efforts to prevent and treat malnutrition; and</text></paragraph><paragraph id="id35aa40b25e3c406abc9ed4410a9358c9"><enum>(6)</enum><text>the constraints on implementation of programs and key lessons learned from programs and activities from the previous fiscal years.</text></paragraph></subsection><subsection id="idf0e25f802ddd452390bdf74f88e36f72"><enum>(b)</enum><header>Use of information</header><text>The Administrator may choose to include the report required in this section as a component of other congressionally mandated reports provided to appropriate congressional committees, as appropriate.</text></subsection></section><section id="id9139850189464439a4a1c7ec3f0fa89b"><enum>7.</enum><header>Compliance with the Foreign Aid Transparency and Accountability Act of 2016</header><text display-inline="no-display-inline">Section 2(3) of the Foreign Aid Transparency and Accountability Act of 2016 (<external-xref legal-doc="public-law" parsable-cite="pl/114/191">Public Law 114–191</external-xref>; <external-xref legal-doc="usc" parsable-cite="usc/22/2394c">22 U.S.C. 2394c</external-xref> note) is amended—</text><paragraph id="id613b2aa81bdc41ab8192f888588d74f0"><enum>(1)</enum><text>in subparagraph (C), by striking <quote>and</quote> at the end;</text></paragraph><paragraph id="id49386b6f9f154d748441f21ea0baf840"><enum>(2)</enum><text>in subparagraph (D), by striking the period at the end and inserting <quote>; and</quote>; and</text></paragraph><paragraph id="id9cb1868a87934d69b0fd17735b4fd0b2"><enum>(3)</enum><text>by adding at the end the following:</text><quoted-block style="OLC" display-inline="no-display-inline" id="id075f96f47e6740088ed11d9d09c238a1"><subparagraph id="idf5b8749d341244fc81ec5ca0a009256b"><enum>(E)</enum><text>the <short-title>Global Malnutrition Prevention and Treatment Act of 2021</short-title>.</text></subparagraph><after-quoted-block>.</after-quoted-block></quoted-block></paragraph></section><section id="idfa9a4be2219f4b039e42079f5f8577ad"><enum>8.</enum><header>Sunset</header><text display-inline="no-display-inline">This Act shall cease to have force or effect beginning on the date that is 7 years after the date of the enactment of this Act. </text></section></legis-body></bill> 

