[Congressional Record Volume 168, Number 69 (Wednesday, April 27, 2022)]
[House]
[Pages H4547-H4550]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




        GLOBAL MALNUTRITION PREVENTION AND TREATMENT ACT OF 2021

  Mr. CONNOLLY. Mr. Speaker, I move to suspend the rules and pass the 
bill (H.R. 4693) to advance targeted and evidence-based interventions 
for the prevention and treatment of global malnutrition and to improve 
the coordination of such programs, and for other purposes.
  The Clerk read the title of the bill.
  The text of the bill is as follows:

                               H.R. 4693

       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 ``Global Malnutrition 
     Prevention and Treatment Act of 2021''.

     SEC. 2. AUTHORIZATION OF EFFORTS TO PREVENT AND TREAT 
                   MALNUTRITION GLOBALLY.

       (a) In General.--The Administrator, in coordination with 
     the heads of other relevant Federal departments and agencies, 
     is authorized and encouraged to support efforts to prevent 
     and treat malnutrition globally, including by--
       (1) targeting resources and nutrition interventions to 
     support the most vulnerable populations susceptible to severe 
     malnutrition, including children under the age of 5 and 
     pregnant and lactating women;
       (2) increasing coverage, particularly in priority 
     countries, of nutrition interventions that include 
     coordinated deployment of prenatal nutrient supplements, 
     breastfeeding support, vitamin A supplementation, specialized 
     nutritious food products for the treatment of acute 
     malnutrition, and other evidence-based interventions, as 
     appropriate;
       (3) increasing the use of context and country-appropriate 
     fortification of staples and condiments with essential 
     nutrients;
       (4) advancing evidence-based programs and interventions 
     carried out using data-driven approaches, best practices, and 
     targeted to country-specific contexts and needs;
       (5) supporting partner governments to develop policies to 
     prevent and treat malnutrition;
       (6) leveraging investments to strengthen health systems, 
     including to support community health workers to advance 
     improved nutrition outcomes;
       (7) improve diets through safe, affordable, nutritious 
     foods in the food system; and
       (8) ensuring rigorous monitoring and evaluation of such 
     efforts.
       (b) External Coordination Efforts Related to Nutrition 
     Programs.--The Administrator, in coordination with the heads 
     of other relevant Federal departments and agencies, should 
     coordinate, as appropriate, with bilateral and multilateral 
     donors, governments of partner countries, United Nations 
     agencies, civil society organizations, nongovernmental 
     organizations, including faith-based organizations, and the 
     private sector to prevent and treat malnutrition globally, 
     including by supporting efforts to--
       (1) build the capacity of local and community-based 
     organizations and governments of partner countries to ensure 
     sustainability of nutrition interventions;
       (2) expand research and innovation to identify and increase 
     effective and evidence-based nutrition interventions based on 
     country-specific contexts;
       (3) improve coordination and structure of supply chains for 
     nutrition interventions;
       (4) expand domestic resource mobilization and domestic 
     financing for nutrition interventions; and
       (5) seek to leverage additional resources and encourage 
     investment into innovative and multi-stakeholder finance 
     partnerships to advance burden sharing in nutrition-related 
     assistance.
       (c) Interagency Efforts.--In carrying out subsections (a) 
     and (b), the Administrator, in coordination with the heads of 
     other relevant Federal departments and agencies, consistent 
     with the Global Nutrition Coordination Plan, shall seek to 
     leverage additional resources to prevent and treat 
     malnutrition globally, including by--
       (1) increasing cooperation among relevant Federal 
     departments and agencies represented in the Global Nutrition 
     Coordination Plan to better leverage grants, technical 
     assistance, debt, equity, loan guaranties, and public-private 
     partnerships; and
       (2) utilizing the Administrator's role as a member of the 
     Board of Directors of the United States International 
     Development Finance Corporation to consider opportunities 
     within the Corporation's development impact framework that 
     support improved nutrition outcomes.

     SEC. 3. SELECTION OF PRIORITY COUNTRIES.

       (a) In General.--The Administrator, in coordination with 
     the Nutrition Leadership Council, shall select foreign 
     countries as priority countries for purposes of targeting 
     programs to prevent and treat malnutrition globally.

[[Page H4548]]

       (b) Criteria.--The selection of priority countries under 
     subsection (a) shall be based on the following:
       (1) The prevalence of severe malnutrition among children 
     under the age of 5 and pregnant and lactating women.
       (2) The presence of high-need, underserved, marginalized, 
     vulnerable, or impoverished communities.
       (3) The enabling environment for improved nutrition, 
     including presence of national nutrition plans and 
     demonstration of strong political commitment.
       (4) Any other criteria that the Administrator determines to 
     be appropriate.
       (c) Updates.--The Administrator shall update the selection 
     of priority countries under subsection (a) not later than 5 
     years after the date of the enactment of this Act.
       (d) Sense of Congress.--It is the sense of Congress that 
     the Administrator should continue to undertake nutrition 
     interventions in countries not selected as priority 
     countries, particularly in contexts in which opportunities 
     are identified to advance multi-sectoral development 
     programming and integrate efforts to prevent and treat global 
     malnutrition with other priority areas and program 
     objectives.

     SEC. 4. NUTRITION LEADERSHIP COUNCIL.

       (a) Establishment.--The Administrator is authorized to 
     establish in the United States Agency for International 
     Development the Nutrition Leadership Council (in this section 
     referred to as the ``Council''), which shall coordinate 
     Agency efforts to prevent and treat malnutrition globally.
       (b) Duties.--The duties of the Council shall include--
       (1) advancing United States Agency for International 
     Development efforts to prevent and treat malnutrition 
     globally;
       (2) ensuring nutrition interventions, particularly in 
     priority countries, are carried out in close coordination 
     with other relevant United States Government strategies and 
     policies and provisions of law, including--
       (A) the Global Food Security Act of 2016 (22 U.S.C. 9301 et 
     seq.);
       (B) the Senator Paul Simon Water for the World Act of 2014 
     (22 U.S.C. 2151 note);
       (C) the Global Child Thrive Act of 2020 (subtitle I of 
     title XII of division A of Public Law 116-283); and
       (D) the Global Fragility Act of 2019 (22 U.S.C. 9801 et 
     seq.); and
       (3) ensuring nutrition interventions are coordinated with 
     nutrition programs carried out by other relevant Federal 
     departments and agencies.
       (c) Membership.--The Council shall include representatives 
     of the following bureaus and independent offices of the 
     United States Agency for International Development:
       (1) The Bureau for Global Health.
       (2) The Bureau for Resilience and Food Security.
       (3) The Bureau for Humanitarian Assistance.
       (4) Any other relevant bureau or independent office that 
     the Administrator determines to be appropriate.

     SEC. 5. IMPLEMENTATION PLAN.

       (a) In General.--Not later than 260 days after the date of 
     the enactment of this Act, the Administrator, in coordination 
     with the heads of other relevant Federal departments and 
     agencies, shall develop and submit to the appropriate 
     congressional committees an implementation plan for programs 
     to prevent and treat malnutrition globally described in 
     section 2.
       (b) Matters To Be Included.--The implementation plan 
     required by subsection (a) shall include the following:
       (1) A description of specific and measurable goals, 
     objectives, and performance metrics with respect to such 
     programs, including clear benchmarks and intended timelines 
     for achieving such goals and objectives.
       (2) A description of monitoring and evaluation plans with 
     respect to such programs, as appropriate.
       (3) In priority countries, a description of efforts to 
     ensure that nutrition is adequately addressed in 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.
       (c) Consultation.--The implementation plan required by 
     subsection (a) shall be developed in consultation with, as 
     appropriate and to the extent possible, representatives of 
     nongovernmental organizations, including faith-based 
     organizations, civil society organizations, multilateral 
     organizations and donors, relevant private, academic, and 
     philanthropic entities, and the appropriate congressional 
     committees.

     SEC. 6. REPORT.

       (a) In General.--Not later than one year after the date of 
     the enactment of this Act, and annually thereafter for 5 
     years, the Administrator shall submit to the appropriate 
     congressional committees a report that describes progress 
     made towards preventing and treating malnutrition globally.
       (b) Matters To Be Included.--The report required by 
     subsection (a) shall include the following:
       (1) A summary of progress made towards achieving the 
     specific and measurable goals, objectives, and performance 
     metrics towards ending global malnutrition.
       (2) In priority countries--
       (A) a detailed summary of nutrition programs and activities 
     in the previous fiscal year, including a breakdown of the 
     countries to which nutrition resources have been allocated 
     and an estimated number of people reached through nutrition 
     interventions; and
       (B) an description of the coordination of nutrition 
     programs with other health and development programs and 
     priorities.
       (3) A summary of efforts to expand research and innovation 
     to development and scale up new tools to prevent and treat 
     malnutrition globally.
       (4) An assessment of the collaboration and coordination of 
     nutrition efforts of the United States Agency for 
     International Development with United Nations agencies, the 
     World Bank, other donor governments, host country 
     governments, civil society, and the private sector, as 
     appropriate.
       (5) A description of other donor country and host country 
     financial commitments and efforts to prevent and treat 
     malnutrition.
       (6) An identification of constraints on implementation of 
     programs and activities and lessons learned from programs and 
     activities from the previous fiscal years.
       (c) Inclusion in Other Reports.--The Administrator may 
     include the report required by subsection (a) as a component 
     of other congressionally mandated reports provided to 
     appropriate congressional committees, as appropriate.

     SEC. 7. COMPLIANCE WITH THE FOREIGN AID TRANSPARENCY AND 
                   ACCOUNTABILITY ACT OF 2016.

       Section 2(3) of the Foreign Aid Transparency and 
     Accountability Act of 2016 (22 U.S.C. 2394c note) is 
     amended--
       (1) in subparagraph (C), by striking ``and'' at the end;
       (2) in subparagraph (D), by striking the period at the end 
     and inserting ``; and''; and
       (3) by adding at the end the following:
       ``(E) the Global Malnutrition Prevention and Treatment Act 
     of 2021.''.

     SEC. 8. 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 Affairs and the Committee on 
     Appropriations of the House of Representatives; and
       (B) the Committee on Foreign Relations and the Committee on 
     Appropriations of the Senate.
       (3) Nutrition leadership council.--The term ``Nutrition 
     Leadership Council'' means Nutrition Leadership Council 
     established by section 4.
       (4) Priority country.--The term ``priority country'' means 
     a foreign country selected under section 3 for purposes of 
     targeting programs to prevent and treat malnutrition 
     globally.

     SEC. 9. SUNSET.

       The requirements of this Act and the amendments made by 
     this Act shall terminate on the date that is 7 years after 
     the date of the enactment of this Act.

  The SPEAKER pro tempore. Pursuant to the rule, the gentleman from 
Virginia (Mr. Connolly) and the gentleman from Pennsylvania (Mr. 
Meuser) each will control 20 minutes.
  The Chair recognizes the gentleman from Virginia.


                             General Leave

  Mr. CONNOLLY. Mr. Speaker, I ask unanimous consent that all Members 
have 5 legislative days in which to revise and extend their remarks and 
include extraneous material on H.R. 4693.
  The SPEAKER pro tempore. Is there objection to the request of the 
gentleman from Virginia?
  There was no objection.
  Mr. CONNOLLY. Mr. Speaker, I yield myself such time as I may consume.
  Mr. Speaker, I rise today in support of H.R. 4693, the Global 
Malnutrition Prevention and Treatment Act of 2021.
  In the wake of COVID-19, we have seen malnutrition rates climb and 
food insecurity become an ever-greater challenge. Jarringly, it is 
predicted that disruptions to global food and health systems will 
double global malnutrition rates--double--with women and children 
bearing the brunt of those effects. It is estimated that in 2022 the 
devastating global effects of COVID-19 could add an additional 17 
million severely malnourished children worldwide. We cannot stand by 
while millions of children's lives are on the line with COVID, climate 
change, and conflict worsening the global situation. That is why the 
Foreign Affairs Committee took action with H.R. 4693 which will direct 
USAID to implement solutions to prevent and treat this global 
malnutrition.
  This bill establishes a nutrition leadership council to identify 
populations most at risk to severe malnutrition and to prioritize 
prevention and treatment programs. Preventing and treating malnutrition 
is relatively inexpensive to implement and has high returns. With every 
$1 we spend, we improve health and increase cognitive

[[Page H4549]]

and physical development yielding the equivalent of a $35 return.
  By coordinating activities throughout the U.S. Government with our 
partner countries with the Untied Nations' specialized agencies, civil 
society, private-sector actors and more, we can sustain nutrition 
interventions that save lives.
  This bill also requires USAID to provide Congress an implementation 
plan and annual reports concerning its programs for treating and 
preventing malnutrition.
  Mr. Speaker, we must do more to support those in dire need, and we 
must answer their call for help. H.R. 4693 is this Chamber's 
opportunity to do just that: to prevent the lives of those suffering 
from malnutrition all around the world. This measure builds on the work 
and jurisdiction of USAID and will bolster efforts to respond to and 
prevent malnutrition everywhere.
  While the United States has led the world in responding to COVID-19 
and its effects around the world, we must also ensure we don't lose 
ground in longstanding investments such as food security. By supporting 
this legislation we can take a meaningful step in doing both.
  Mr. Speaker, I urge my colleagues to support this measure so we can 
move it one step closer to the President's desk, and I reserve the 
balance of my time.
  Mr. MEUSER. Mr. Speaker, I yield myself such time as I may consume.
  Mr. Speaker, as we speak, millions of women and children are on the 
brink of starvation around the world. An estimated 3.1 million children 
perish every year due to malnutrition. In fact, almost half of the 
deaths among children under the age of 5 are linked to malnutrition, 
mainly in low- and middle-income countries. In the 21st century this 
tragedy should be prevented.
  This bipartisan bill will support efforts to scale up targeted and 
effective nutrition programs in countries most at risk for severe 
malnutrition. That will help us have a real impact on people's lives 
around the world.
  Fallout from the Russian invasion of Ukraine and the administration's 
chaotic and deadly withdrawal from Afghanistan have compounded global 
humanitarian crises. Coupled with the COVID-19 pandemic, now more than 
ever we must do everything we can to advance lifesaving nutrition 
programs, and that starts with a strong and effective USAID who has the 
tools it needs to ensure no child dies from malnutrition.
  Every parent wants to be able to put food on the table, nourish their 
families, and provide for themselves. Support for low-cost, effective 
nutrition interventions mean an investment in the health, development, 
and productivity of the next generation of children, and I urge my 
colleagues to support this important measure.
  In closing, Mr. Speaker, in addition to the crises in Ukraine, 
Afghanistan, and Ethiopia, the COVID-19 pandemic has erased years of 
progress towards ending extreme poverty. It has pushed more people into 
severe food insecurity and malnutrition and has destabilized fragile 
states. This legislation will help us reclaim lost ground in the battle 
against hunger and malnutrition.
  USAID plays a pivotal role in helping nations across the globe combat 
hunger and poverty. The agency, alongside our NGO and private-sector 
partners, has helped secure nutrition stability for expectant mothers 
and young children along with countless others in need, but more must 
be done to truly end starvation.
  I want to thank members of the advocacy community, especially Bread 
for the World and RESULTS, for their continued support of this 
legislative effort.
  Mr. Speaker, I am grateful we can continue the long history of 
bipartisan cooperation to help those in need around the world, and I 
yield back the balance of my time.

                              {time}  1445

  Mr. CONNOLLY. Mr. Speaker, I yield myself the balance of my time.
  The United States has a long tradition, on a bipartisan basis, of 
dealing with the issue of food insecurity and malnutrition. Herbert 
Hoover led some of the early efforts by the United States Government 
after World War I to feed a starving Europe. He even provided food 
assistance to the Bolshevik regime in Russia because we understood that 
malnutrition didn't respect political ideology or labels.
  Through the Food for Peace program in the early Kennedy and Johnson 
years, there was cooperation between the late Senator Bob Dole and the 
late Senator George McGovern to make sure that both domestic and 
international food security were staples of U.S. policy and bipartisan 
support.
  This is an important piece of legislation. No child in 2022 should 
ever be malnourished, and certainly, no child should ever die from 
malnourishment.
  This is an important statement by this Congress about our values as 
human beings and as a society and reaffirms a longstanding commitment 
by the American people to not let this kind of tragedy happen anywhere.
  Mr. Speaker, I urge passage of the bill, and I yield back the balance 
of my time.
  Ms. JACKSON LEE. Mr. Speaker, I rise in strong support of H.R. 4693, 
Global Malnutrition Prevention and Treatment Act of 2021, which will 
establish programs and direct the U.S. Agency for International 
Development (USAID) to carry out activities to prevent and treat 
malnutrition globally.
  This bill would advance targeted and evidence-based interventions for 
the prevention and treatment of global malnutrition and to improve the 
coordination of such programs.
  Under this bill, USAID must leverage resources to address 
malnutrition through the Global Nutrition Coordination Plan and its 
role on the board of directors of the International Development of 
Finance Corporation.
  The Global Nutrition Coordination plan is an interagency effort to 
strengthen the impact of U.S. investments in nutrition.
  USAID must also select countries based on specific malnutrition-
related indicators for the purpose of targeting malnutrition prevention 
and treatment programs.
  The plan will prioritize high-need, underserved, marginalized or 
impoverished communities.
  However, countries must display strong political commitment and have 
existing nutrition strategies already in place, which ensures that the 
plan to combat malnutrition in a select country will be effective and 
impactful.
  Additionally, USAID may:
  establish the Nutrition Leadership Council to coordinate activities 
to prevent and treat malnutrition;
  target resources and nutrition interventions to the populations most 
susceptible to severe malnutrition, and otherwise support efforts to 
prevent and treat malnutrition globally;
  coordinate activities among partner countries, United Nations 
agencies, civil society, private sector actors, and others to, for 
example, build capacity in partner countries to sustain nutrition 
interventions.
  USAID would also be required to provide Congress with an 
implementation plan and annual reports concerning the programs for 
treating and preventing malnutrition.
  As a senior Member of the House of Representatives and the founding 
chair of the Congressional Children's Caucus, I believe this bill is 
vital for preventing and treating malnutrition around the world.
  We must ensure continued focus on multi-sectoral nutrition programs, 
while monitoring these interventions to ensure effective use of 
American taxpayer dollars.
  I commend the USAID maternal and child nutrition programs that seek 
to improve health outcomes by implementing nutrition-specific 
interventions, and those that address the immediate, health-related 
determinants of undernutrition.
  It is no secret that poverty amplifies the risk of malnutrition.
  People who are poor are more likely to be affected by different forms 
of malnutrition.
  Furthermore, malnutrition increases health care costs, reduces 
productivity, and slows economic growth, which can perpetuate a cycle 
of poverty and ill-health.
  Malnutrition can have several negative and deadly effects such as 
decreased cognitive development in newborns, greater vulnerability to 
disease and other issues.
  Optimizing nutrition early in life, especially from the 1,000 days 
from conception to a child's second birthday ensures the best possible 
start in life, with long-term benefits.
  According to UNICEF, nearly half of all deaths in children under 5 
are attributable to undernutrition.
  Every year, the world loses hundreds of thousands of young children 
and babies to hunger-related causes.
  Women, infants, children, and adolescents are at particular risk of 
malnutrition.
  I would be remiss if I stood here today without addressing the global 
impact of COVID-19 on malnutrition.
  The significant and life-altering shocks created by the pandemic and 
efforts to mitigate the transmission of COVID-19 have resulted in the 
disruption of food systems.

[[Page H4550]]

  This has also upended health and nutrition services which has 
devastated livelihoods, as well as threatened food security.
  These necessary containment measures have unfortunately caused more 
vulnerable children to face malnourishment.
  By the end of this year nearly 14 million more children are likely to 
be severely malnourished because of the pandemic's impacts.
  This means that 58.9 million young children--or almost the whole 
population of South Africa--will likely face life-threatening 
malnutrition if the global community doesn't act.
  The pandemic revealed the already existing brutal food insecurity 
struggles in many nations while triggering economic recessions and 
jeopardizing access to food.
  The combined impacts of environmental factors, COVID-19 and political 
conflicts place malnutrition as an overwhelming concern in the global 
community.
  I ask my colleagues to join me in voting for H.R. 4693 because with 
this bill we are committing ourselves to improving the health of women 
and children in impoverished areas, helping prevent illness, and 
improving economic conditions in poorer countries.
  Every parent deserves the opportunity to put nutritional food on the 
table to take care of their families.
  By supporting these effective nutrition interventions, we unlock the 
ability to begin investing in the well-being, growth, and productivity 
of our generations to come.
  The SPEAKER pro tempore. The question is on the motion offered by the 
gentleman from Virginia (Mr. Connolly) that the House suspend the rules 
and pass the bill, H.R. 4693.
  The question was taken.
  The SPEAKER pro tempore. In the opinion of the Chair, two-thirds 
being in the affirmative, the ayes have it.
  Mr. FULCHER. Mr. Speaker, on that I demand the yeas and nays.
  The SPEAKER pro tempore. Pursuant to section 3(s) of House Resolution 
8, the yeas and nays are ordered.
  Pursuant to clause 8 of rule XX, further proceedings on this motion 
are postponed.

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