[Congressional Record Volume 153, Number 82 (Thursday, May 17, 2007)]
[Senate]
[Pages S6269-S6272]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

      By Mr. DODD (for himself, Mr. Brown, Mr. Smith, and Mr. Leahy):
  S. 1418. A bill to provide assistance to improve the health of 
newborns, children, and mothers in developing countries, and for other 
purposes; to the Committee on Foreign Relations.
  Mr. DODD. Mr. President, I rise today to introduce, on behalf of 
myself and good friend, Senator Gordon Smith, the United States 
Commitment to Global Child Survival Act of 2007.
  This bill seeks to drastically reduce child and maternal mortality 
rates abroad. It is a goal entirely within our reach, relying on tools 
that are already within our grasp. We have the power to save millions 
of innocent lives; and there is no better measure for the success of 
our foreign aid.
  The legislation would perform three simple yet vital functions. 
First, it would require the administration to develop and implement a 
strategy to improve the health of, and reduce mortality rates among, 
newborns, children, and mothers in developing countries.
  Second, it would establish a task force to monitor and evaluate the 
progress of the relevant departments and agencies of our Government in 
meeting by 2015 the U.N. Millennium Development Goals related to 
reducing mortality rates for mothers and for children under 5.
  Third, it would authorize appropriations for programs that improve 
the health of newborns, children, and mothers in developing countries. 
Specifically, it would increase funding for child survival programs 
from the current level of around $350 million to $600 million in fiscal 
year 2008, $900 million in fiscal year 2009, $1.2 billion in fiscal 
year 2010, and up to $1.6 billion in fiscal year 2011-2012.
  I know that some of my colleagues will dispute the wisdom of such a 
large investment. None of them would deny this issue's importance; but 
some may question its priority. How can we answer them?
  In a world of seemingly intractable problems, we have here an 
opportunity for quick and uncomplicated success. Each dollar we spend 
in this cause helps to save a vulnerable life.
  And what is more, we have already given our word. As part of the 
Millennium Development Goals, the United States made an explicit 
commitment, along with 188 other countries, to reducing child and 
maternal mortality. But at current funding levels, we are set to renege 
on that promise by a wide margin.
  On September 14, 2005, President Bush stated that the United States 
is ``committed to the Millennium Development Goals.'' I commend the 
President for his words, but they have not been matched with action.
  As we reach the goals' halfway mark, the world's progress is 
distressingly slow. The leading medical journal The Lancet reports 
that, of the 60 countries accounting for 90 percent of child

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deaths, ``only 7 are on track to meet the goal for reducing child 
mortality, 39 are making some progress, and 14 are cause for serious 
concern.''
  Now what does that mean in real, human terms? It means each year over 
10 million children under the age of 5 die in the developing world, 
that's approximately 30,000 each day. About 4 million of those children 
die in their first 4 weeks of life. In many cases, they aren't even 
provided with a fighting chance. Preventable or treatable diseases such 
as measles, tetanus, diarrhea, pneumonia, and malaria are the most 
common causes of death.
  Similarly, more than 525,000 women die from causes related to 
pregnancy and childbirth, more than 1,400 each day. Some of the most 
common risk factors for maternal death include early pregnancy and 
childbirth, closely spaced births, infectious diseases, malnutrition, 
and complications during childbirth.
  Nearly every one of those deaths is entirely preventable. And that 
fact makes a poor American commitment inexcusable.
  That commitment will not require new medicine. It will not require 
sophisticated technology. The tools we need are already at hand. Even 
now, simple measures are saving lives in the developing world.
  Studies in the Lancet tell us that, for just over $5 billion, the 
world could prevent two-thirds of under-5 child deaths with proven, 
low-cost, high-impact interventions. For 6 million lives, that is a 
bargain.
  How cheap are these lifesaving measures? Oral rehydration therapy for 
diarrhea costs 6 cents per treatment. Antibiotics to treat respiratory 
infections cost a quarter per treatment. Encouraging breastfeeding, 
providing vitamin supplements and immunizations, and expanding basic 
clinical care are just as cost effective.
  This bill incrementally scales up U.S. funding for child and maternal 
health programs up to $1.6 billion by 2011. That is a third of the 
money the world needs to save those 6 million children's lives, and it 
is proportionate to our efforts against HIV/AIDS, TB, and malaria. And 
it is less money than we spend in Iraq in just 1 week. Yes, 1 week.
  To be clear, America is not new to this battle. We've had some 
significant successes: Between 1960 and 1990, U.S. investment in 
reducing child mortality in the developing world contributed to a 50 
percent reduction in under-5 deaths. Over the past 20 years, we have 
devoted over $6 billion to child survival programs.
  But as I have noted, at current funding levels in the U.S. and 
abroad, the world will not meet the Millennium Development Goals. 
Certainly, America cannot meet them alone. But with a strong effort, we 
can galvanize other nations to do their part and come forward with the 
funds we need to save lives.
  So I am proud to offer the Global Child Survival Act of 2007, a bill 
with widespread, bipartisan, bicameral support. It has been endorsed by 
Save the Children, the US Fund for UNICEF, and the One Campaign; is 
being jointly introduced with my good friend Senator Gordon Smith from 
across the aisle; and was introduced last week in the House in a 
bipartisan manner by Congresswoman Betty McCollum and Congressman Chris 
Shays.
  For me it's simple. As the world's only superpower and largest 
economy, the United States is in a unique position to tackle the 
toughest challenges of our times. Where we can make a concrete 
difference, we must not fail to act. Where we have the tools to 
alleviate death and suffering, we must deliver them.
  So I urge my colleagues to support this bill. Millions of lives are 
in the balance.
  I ask unanimous consent that the text of the bill be printed in the 
Record.
  There being no objection, the text of the bill was ordered to be 
printed in the Record, as follows:

                                S. 1418

       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 ``United States Commitment to 
     Global Child Survival Act of 2007''.

     SEC. 2. FINDINGS AND PURPOSES.

       (a) Findings.--Congress makes the following findings:
       (1) In 2000, the United States joined 188 countries in 
     committing to achieve 8 Millennium Development Goals (MDGs) 
     by 2015, including ``MDG 4'' and ``MDG 5'' that aim to reduce 
     the mortality rate of children under the age of 5 by \2/3\ 
     and maternal mortality rate by \3/4\ in developing countries, 
     respectively.
       (2) The significant commitment of the United States to 
     reducing child mortality in the developing world contributed 
     to a 50-percent reduction in the mortality rate of children 
     under the age of 5 between 1960 and 1990, and over the past 
     20 years, the United States has invested over $6,000,000,000 
     in child survival programs run by the United States Agency 
     for International Development.
       (3) According to one of the world's leading medical 
     journals, the Lancet, despite United States and global 
     efforts to achieve MDG 4, of the 60 countries that account 
     for 94 percent of under-5 child deaths, ``only seven 
     countries are on track to meet MDG 4, thirty-nine countries 
     are making some progress, although they need to accelerate 
     the speed, and fourteen countries are cause for serious 
     concern''.
       (4) 10,500,000 children under the age of 5 die annually, 
     over 29,000 children per day, from easily preventable and 
     treatable causes, including 4,000,000 newborns who die in the 
     first 4 weeks of life.
       (5) 3,000,000 children die each year due to lack of access 
     to low-cost antibiotics and antimalarial drugs, and 1,700,000 
     die from diseases for which vaccines are readily available.
       (6) Maternal health is an important determinant of neonatal 
     survival with maternal death increasing death rates for 
     newborns to as high as 100 percent in certain countries in 
     the developing world.
       (7) Approximately 525,000 women die every year in the 
     developing world from causes related to pregnancy and 
     childbirth.
       (8) Risk factors for maternal death in developing countries 
     include pregnancy and childbirth at an early age, closely 
     spaced births, infectious diseases, malnutrition, and 
     complications during childbirth.
       (9) According to the Lancet, nearly \2/3\ of annual child 
     and newborn deaths, 6,000,000 children, can be avoided in 
     accordance with MDG 4 if a package of high impact, low-cost 
     interventions were made available at a total, additional, 
     annual cost of $5,100,000,000, including oral rehydration 
     therapy for diarrhea ($0.06 per treatment) and antibiotics to 
     treat respiratory infections ($0.25 per treatment).
       (10) 2,000,000 lives could be saved annually by providing 
     oral rehydration therapy prepared with clean water.
       (11) Exclusive breastfeeding--giving only breast milk for 
     the first 6 months of life--could prevent an estimated 
     1,300,000 newborn and infant deaths each year, primarily by 
     protecting against diarrhea and pneumonia.
       (12) Expansion of clinical care for newborns and mothers, 
     such as clean delivery by skilled attendants, emergency 
     obstetric care, and neonatal resuscitation, can avert 50 
     percent of newborn deaths and reduce maternal mortality.
       (13) The United Nations Children's Fund (UNICEF), with 
     support from the World Health Organization, the World Bank, 
     and the African Union, has successfully demonstrated the 
     accelerated child survival and development program in 
     Senegal, Mali, Benin, and Ghana, reducing mortality of 
     children under the age of 5 by 20 percent in targeted areas 
     using low-cost, high-impact interventions.
       (14) On September 14, 2005, President George W. Bush stated 
     before the United Nations High-Level Plenary Meeting that the 
     United States is ``committed to the Millennium Development 
     Goals''.
       (15) Nearing the halfway point of attaining the MDGs by 
     2015 with thousands of avoidable newborn, child, and maternal 
     deaths still occurring, the United States must immediately 
     scale up its funding and delivery of proven low-cost, life-
     saving interventions in order to fulfill its commitment to 
     help ensure that MDGs 4 and 5 are met.
       (b) Purposes.--The purposes of this Act are--
       (1) to develop a strategy to reduce mortality and improve 
     the health of newborns, children, and mothers, and authorize 
     assistance for its implementation; and
       (2) to establish a task force to assess, monitor, and 
     evaluate the progress and contributions of relevant 
     departments and agencies of the United States Government in 
     achieving MDGs 4 and 5.

     SEC. 3. ASSISTANCE TO IMPROVE THE HEALTH OF NEWBORNS, 
                   CHILDREN, AND MOTHERS IN DEVELOPING COUNTRIES.

       (a) In General.--Chapter 1 of part I of the Foreign 
     Assistance Act of 1961 (22 U.S.C. 2151 et seq.) is amended--
       (1) in section 104(c)--
       (A) by striking paragraphs (2) and (3); and
       (B) by redesignating paragraph (4) as paragraph (2); and
       (2) by inserting after section 104C the following new 
     section:

     ``SEC. 104D. ASSISTANCE TO REDUCE MORTALITY AND IMPROVE THE 
                   HEALTH OF NEWBORNS, CHILDREN, AND MOTHERS.

       ``(a) Authorization.--Consistent with section 104(c), the 
     President is authorized to furnish assistance, on such terms 
     and conditions as the President may determine, to reduce 
     mortality and improve the health of

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     newborns, children, and mothers in developing countries.
       ``(b) Activities Supported.--Assistance provided under 
     subsection (a) shall, to the maximum extent practicable, be 
     used to carry out the following activities:
       ``(1) Activities to improve newborn care and treatment.
       ``(2) Activities to treat childhood illness, including 
     increasing access to appropriate treatment for diarrhea, 
     pneumonia, and other life-threatening childhood illnesses.
       ``(3) Activities to improve child and maternal nutrition, 
     including the delivery of iron, zinc, vitamin A, iodine, and 
     other key micronutrients and the promotion of breastfeeding.
       ``(4) Activities to strengthen the delivery of immunization 
     services, including efforts to eliminate polio.
       ``(5) Activities to improve birth preparedness and 
     maternity services.
       ``(6) Activities to improve the recognition and treatment 
     of obstetric complications and disabilities.
       ``(7) Activities to improve household-level behavior 
     related to safe water, hygiene, exposure to indoor smoke, and 
     environmental toxins such as lead.
       ``(8) Activities to improve capacity for health governance, 
     health finance, and the health workforce, including support 
     for training clinicians, nurses, technicians, sanitation and 
     public health workers, community-based health works, 
     midwives, birth attendants, peer educators, volunteers, and 
     private sector enterprises.
       ``(9) Activities to address antimicrobial resistance in 
     child and maternal health.
       ``(10) Activities to establish and support the management 
     information systems of host country institutions and the 
     development and use of tools and models to collect, analyze, 
     and disseminate information related to newborn, child, and 
     maternal health.
       ``(11) Activities to develop and conduct needs assessments, 
     baseline studies, targeted evaluations, or other information-
     gathering efforts for the design, monitoring, and evaluation 
     of newborn, child, and maternal health efforts.
       ``(12) Activities to integrate and coordinate assistance 
     provided under this section with existing health programs 
     for--
       ``(A) the prevention of the transmission of HIV from 
     mother-to-child and other HIV/AIDS counseling, care, and 
     treatment activities;
       ``(B) malaria;
       ``(C) tuberculosis; and
       ``(D) child spacing.
       ``(c) Guidelines.--To the maximum extent practicable, 
     programs, projects, and activities carried out using 
     assistance provided under this section shall be--
       ``(1) carried out through private and voluntary 
     organizations, including faith-based organizations, and 
     relevant international and multilateral organizations, 
     including the GAVI Alliance and UNICEF, that demonstrate 
     effectiveness and commitment to improving the health of 
     newborns, children, and mothers;
       ``(2) carried out with input by host countries, including 
     civil society and local communities, as well as other donors 
     and multilateral organizations;
       ``(3) carried out with input by beneficiaries and other 
     directly affected populations, especially women and 
     marginalized communities; and
       ``(4) designed to build the capacity of host country 
     governments and civil society organizations.
       ``(d) Annual Report.--Not later than January 31 of each 
     year, the President shall transmit to Congress a report on 
     the implementation of this section for the prior fiscal year.
       ``(e) Definitions.--In this section:
       ``(1) AIDS.--The term `AIDS' has the meaning given the term 
     in section 104A(g)(1) of this Act.
       ``(2) HIV.--The term `HIV' has the meaning given the term 
     in section 104A(g)(2) of this Act.
       ``(3) HIV/AIDS.--The term `HIV/AIDS' has the meaning given 
     the term in section 104A(g)(3) of this Act.''.
       (b) Conforming Amendments.--The Foreign Assistance Act of 
     1961 (22 U.S.C. 2151 et seq.) is amended--
       (1) in section 104(c)(2) (as redesignated by subsection 
     (a)(1)(B) of this section), by striking ``and 104C'' and 
     inserting ``104C, and 104D'';
       (2) in section 104A--
       (A) in subsection (c)(1), by inserting ``and section 104D'' 
     after ``section 104(c)''; and
       (B) in subsection (f), by striking ``section 104(c), this 
     section, section 104B, and section 104C'' and inserting 
     ``section 104(c), this section, section 104B, section 104C, 
     and section 104D'';
       (3) in subsection (c) of section 104B, by inserting ``and 
     section 104D'' after ``section 104(c)'';
       (4) in subsection (c) of section 104C, by inserting ``and 
     section 104D'' after ``section 104(c)''; and
       (5) in the first sentence of section 119(c), by striking 
     ``section 104(c)(2), relating to Child Survival Fund'' and 
     inserting ``section 104D''.

     SEC. 4. DEVELOPMENT OF STRATEGY TO REDUCE MORTALITY AND 
                   IMPROVE THE HEALTH OF NEWBORNS, CHILDREN, AND 
                   MOTHERS IN DEVELOPING COUNTRIES.

       (a) Development of Strategy.--The President shall develop 
     and implement a comprehensive strategy to improve the health 
     of newborns, children, and mothers in developing countries.
       (b) Components.--The comprehensive United States Government 
     strategy developed pursuant to subsection (a) shall include 
     the following:
       (1) An identification of not less than 60 countries with 
     priority needs for the 5-year period beginning on the date of 
     the enactment of this Act based on--
       (A) the number and rate of neonatal deaths;
       (B) the number and rate of child deaths; and
       (C) the number and rate of maternal deaths.
       (2) For each country identified in paragraph (1)--
       (A) an assessment of the most common causes of newborn, 
     child, and maternal mortality;
       (B) a description of the programmatic areas and 
     interventions providing maximum health benefits to 
     populations at risk and maximum reduction in mortality;
       (C) an assessment of the investments needed in identified 
     programs and interventions to achieve the greatest results;
       (D) a description of how United States assistance 
     complements and leverages efforts by other donors and builds 
     capacity and self-sufficiency among recipient countries; and
       (E) a description of goals and objectives for improving 
     newborn, child, and maternal health, including, to the extent 
     feasible, objective and quantifiable indicators.
       (3) An expansion of the Child Survival and Health Grants 
     Program of the United States Agency for International 
     Development, at least proportionate to any increase in child 
     and maternal health assistance, to provide additional support 
     programs and interventions determined to be efficacious and 
     cost-effective.
       (4) Enhanced coordination among relevant departments and 
     agencies of the United States Government engaged in 
     activities to improve the health and well-being of newborns, 
     children, and mothers in developing countries.
       (5) A description of the measured or estimated impact on 
     child morbidity and mortality of each project or program.
       (c) Report.--Not later than 180 days after the date of the 
     enactment of this Act, the President shall transmit to 
     Congress a report that contains the strategy described in 
     this section.

     SEC. 5. INTERAGENCY TASK FORCE ON CHILD SURVIVAL AND MATERNAL 
                   HEALTH IN DEVELOPING COUNTRIES.

       (a) Establishment.--There is established a task force to be 
     known as the Interagency Task Force on Child Survival and 
     Maternal Health in Developing Countries (in this section 
     referred to as the ``Task Force'').
       (b) Duties.--
       (1) In general.--The Task Force shall assess, monitor, and 
     evaluate the progress and contributions of relevant 
     departments and agencies of the United States Government in 
     achieving MDGs 4 and 5 in developing countries, including 
     by--
       (A) identifying and evaluating programs and interventions 
     that directly or indirectly contribute to the reduction of 
     child and maternal mortality rates;
       (B) assessing effectiveness of programs, interventions, and 
     strategies toward achieving the maximum reduction of child 
     and maternal mortality rates;
       (C) assessing the level of coordination among relevant 
     departments and agencies of the United States Government, the 
     international community, international organizations, faith-
     based organizations, academic institutions, and the private 
     sector;
       (D) assessing the contributions made by United States-
     funded programs toward achieving MDGs 4 and 5;
       (E) identifying the bilateral efforts of other nations and 
     multilateral efforts toward achieving MDGs 4 and 5; and
       (F) preparing the annual report required by subsection (f).
       (2) Consultation.--To the maximum extent practicable, the 
     Task Force shall consult with individuals with expertise in 
     the matters to be considered by the Task Force who are not 
     officers or employees of the United States Government, 
     including representatives of United States-based 
     nongovernmental organizations (including faith-based 
     organizations and private foundations), academic 
     institutions, private corporations, the United Nations 
     Children's Fund (UNICEF), and the World Bank.
       (c) Membership.--
       (1) Number and appointment.--The Task Force shall be 
     composed of the following members:
       (A) The Administrator of the United States Agency for 
     International Development.
       (B) The Assistant Secretary of State for Population, 
     Refugees and Migration.
       (C) The Coordinator of United States Government Activities 
     to Combat HIV/AIDS Globally.
       (D) The Director of the Office of Global Health Affairs of 
     the Department of Health and Human Services.
       (E) The Under Secretary for Food, Nutrition and Consumer 
     Services of the Department of Agriculture.
       (F) The Chief Executive Officer of the Millennium Challenge 
     Corporation.
       (G) Other officials of relevant departments and agencies of 
     the Federal Government who shall be appointed by the 
     President.
       (H) Two ex officio members appointed by the Speaker of the 
     House of Representatives

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     in consultation with the Minority Leader of the House of 
     Representatives.
       (I) Two ex officio members appointed by the Majority Leader 
     of the Senate in consultation with the Minority Leader of the 
     Senate.
       (2) Chairperson.--The Administrator of the United States 
     Agency for International Development shall serve as 
     chairperson of the Task Force.
       (d) Meetings.--The Task Force shall meet on a regular 
     basis, not less often than quarterly, on a schedule to be 
     agreed upon by the members of the Task Force, and starting 
     not later than 90 days after the date of the enactment of 
     this Act.
       (e) Definition.--In this subsection, the term ``Millennium 
     Development Goals'' means the key development objectives 
     described in the United Nations Millennium Declaration, as 
     contained in United Nations General Assembly Resolution 55/2 
     (September 2000).
       (f) Report.--Not later than 120 days after the date of the 
     enactment of this Act, and not later than April 30 of each 
     year thereafter, the Task Force shall submit to Congress and 
     the President a report on the implementation of this section.

     SEC. 6. AUTHORIZATION OF APPROPRIATIONS.

       (a) In General.--There are authorized to be appropriated to 
     carry out this Act, and the amendments made by this Act, 
     $600,000,000 for fiscal year 2008, $900,000,000 for fiscal 
     year 2009, $1,200,000,000 for fiscal year 2010, and 
     $1,600,000,000 for each of fiscal years 2011 and 2012.
       (b) Availability of Funds.--Amounts appropriated pursuant 
     to the authorization of appropriations under subsection (a) 
     are authorized to remain available until expended.
                                 ______