Reach Every Mother and Child Act of 2021

II 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 Representa- 1 tives of the United States of America in Congress assembled, 2 SECTION 1. SHORT TITLE. 3 This Act may be cited as the ‘‘Reach Every Mother 4 and Child Act of 2021’’. 5 SEC. 2. ASSISTANCE TO END PREVENTABLE MATERNAL, 6 NEWBORN, AND CHILD DEATHS GLOBALLY. 7 The Foreign Assistance Act of 1961 (22 U.S.C. 2151 8 et seq.) is amended by adding at the end of chapter I of 9 part I the following new section: 10 VerDate Sep 11 2014 01:21 May 25, 2021 Jkt 019200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6201 E:\BILLS\S1451.IS S1451 kjohnson on DSK79L0C42PROD with BILLS 2 •S 1451 IS ‘‘SEC. 138. ASSISTANCE TO END PREVENTABLE MATERNAL, 1 NEWBORN, AND CHILD DEATHS GLOBALLY. 2 ‘‘(a) PURPOSE.—The purpose of this section is to im- 3 plement a strategic approach for providing foreign assist- 4 ance in order to end preventable child and maternal deaths 5 globally by 2030. 6 ‘‘(b) DEFINITIONS.—In this section: 7 ‘‘(1) ADMINISTRATOR.—The term ‘Adminis- 8 trator’ means the Administrator of the United 9 States Agency for International Development. 10 ‘‘(2) APPROPRIATE CONGRESSIONAL COMMIT- 11 TEES.—The term ‘appropriate congressional com- 12 mittees’ means— 13 ‘‘(A) the Committee on Foreign Relations 14 and the Committee on Appropriations of the 15 Senate; and 16 ‘‘(B) the Committee on Foreign Affairs 17 and the Committee on Appropriations of the 18 House of Representatives. 19 ‘‘(3) COORDINATOR.—The term ‘Coordinator’ 20 means the Child and Maternal Survival Coordinator 21 designated under subsection (e). 22 ‘‘(4) INTERNATIONAL MATERNAL AND CHILD 23 HEALTH AND NUTRITION PROGRAMS.—The term 24 ‘international maternal and child health and nutri- 25 tion programs’ means all programs carried out using 26 VerDate Sep 11 2014 01:21 May 25, 2021 Jkt 019200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\S1451.IS S1451 kjohnson on DSK79L0C42PROD with BILLS 3 •S 1451 IS funds appropriated or otherwise made available for 1 international maternal and child health and nutri- 2 tion that are managed by the Bureau for Global 3 Health, missions, or other operating units of the 4 United States Agency for International Develop- 5 ment. 6 ‘‘(5) MOST VULNERABLE POPULATIONS.—The 7 term ‘most vulnerable populations’ includes adoles- 8 cents, populations in conflict-affected or fragile 9 areas, indigenous populations, religious minorities, 10 individuals with disabilities, and the poorest quintile 11 in urban and remote locations. 12 ‘‘(6) PRIORITY COUNTRIES.—The term ‘priority 13 countries’ means countries that have the greatest 14 need and highest burden of child and maternal 15 deaths, taking into consideration countries that— 16 ‘‘(A) have high-need communities in fragile 17 states or conflict-affected states; 18 ‘‘(B) are low- or middle-income countries; 19 or 20 ‘‘(C) are located in regions with weak 21 health systems. 22 ‘‘(7) RELEVANT PARTNER ENTITIES.—The 23 term ‘relevant partner entities’ means each of the 24 following: 25 VerDate Sep 11 2014 01:21 May 25, 2021 Jkt 019200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\S1451.IS S1451 kjohnson on DSK79L0C42PROD with BILLS 4 •S 1451 IS ‘‘(A) The governments of other donor 1 countries. 2 ‘‘(B) International financial institutions. 3 ‘‘(C) Nongovernmental organizations. 4 ‘‘(D) Faith-based organizations. 5 ‘‘(E) Professional organizations. 6 ‘‘(F) The private sector. 7 ‘‘(G) Multilateral organizations. 8 ‘‘(H) Local and international civil society 9 groups. 10 ‘‘(I) Local health workers. 11 ‘‘(J) International organizations. 12 ‘‘(c) STATEMENT OF POLICY.—It is the policy of the 13 United States, in partnership with priority countries and 14 relevant partner entities, to establish and implement a co- 15 ordinated, integrated, and comprehensive strategy to end 16 preventable child and maternal deaths and ensure healthy 17 and productive lives by— 18 ‘‘(1) focusing on bringing to scale the highest- 19 impact, evidence-based interventions that address 20 the leading causes of maternal, newborn, and child 21 mortality in each priority country; 22 ‘‘(2) ensuring equitable access to essential 23 health services for the most vulnerable populations, 24 with a focus on country and community ownership; 25 VerDate Sep 11 2014 01:21 May 25, 2021 Jkt 019200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\S1451.IS S1451 kjohnson on DSK79L0C42PROD with BILLS 5 •S 1451 IS ‘‘(3) designing, implementing, monitoring, and 1 evaluating programs in a manner that enhances 2 transparency and accountability, increases sustain- 3 ability, and improves outcomes in priority countries; 4 and 5 ‘‘(4) supporting the research, development, and 6 introduction of innovative tools and approaches to 7 accelerate progress toward ending preventable child 8 and maternal deaths. 9 ‘‘(d) STRATEGY.— 10 ‘‘(1) IN GENERAL.—Not later than 1 year after 11 the date of the enactment of the Reach Every Moth- 12 er and Child Act of 2021, the President should es- 13 tablish and implement a comprehensive 5-year strat- 14 egy (in this subsection referred to as the ‘strategy’) 15 to contribute toward the global goal of ending pre- 16 ventable child and maternal deaths by 2030 as a 17 foundation for ensuring healthy and productive lives. 18 ‘‘(2) LEADERSHIP.—The Administrator, in co- 19 ordination with priority countries and relevant part- 20 ner entities, shall lead the establishment and imple- 21 mentation of the strategy. 22 ‘‘(3) ELEMENTS.—The strategy should— 23 ‘‘(A) identify priority countries in which 24 the United States Agency for International De- 25 VerDate Sep 11 2014 01:21 May 25, 2021 Jkt 019200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6201 E:\BILLS\S1451.IS S1451 kjohnson on DSK79L0C42PROD with BILLS 6 •S 1451 IS velopment will implement international mater- 1 nal and child health and nutrition programs to 2 reduce maternal, newborn, and child mortality 3 and improve health outcomes; 4 ‘‘(B) with respect to each priority country, 5 identify the most significant barriers to mater- 6 nal, newborn, and child survival and establish 7 outcome-based targets from which progress to- 8 ward addressing those barriers through inter- 9 national maternal and child health and nutri- 10 tion programs can be tracked; 11 ‘‘(C) in coordination with relevant partner 12 entities, outline how the United States Agency 13 for International Development will implement 14 the highest-impact, evidence-based interventions 15 for reducing maternal, newborn, and child mor- 16 tality and expand access to quality services 17 through community-based approaches to achieve 18 the outcome-based targets established under 19 subparagraph (B); 20 ‘‘(D) promote investments in community- 21 based activities that empower women, support 22 voluntarism, and provide respectful maternity 23 care; 24 VerDate Sep 11 2014 01:21 May 25, 2021 Jkt 019200 PO 00000 Frm 00006 Fmt 6652 Sfmt 6201 E:\BILLS\S1451.IS S1451 kjohnson on DSK79L0C42PROD with BILLS 7 •S 1451 IS ‘‘(E) describe how the most vulnerable 1 populations in each priority country will be tar- 2 geted and reached with highest-impact, evi- 3 dence-based interventions to reduce maternal, 4 newborn, and child mortality; 5 ‘‘(F) use United States Government strate- 6 gies and frameworks relevant to improving ma- 7 ternal, newborn, and child health; 8 ‘‘(G) address backsliding on access to and 9 demand for essential health services and other 10 key challenges affecting maternal, newborn, and 11 child survival caused by the COVID–19 pan- 12 demic; 13 ‘‘(H) include development and scale-up of 14 new technologies and approaches, including 15 those supported by public-private partnerships, 16 for research and innovation; 17 ‘‘(I) promote coordination and efficiency 18 within and among the relevant executive branch 19 agencies and initiatives, including the United 20 States Agency for International Development, 21 the Department of State, the Department of 22 Health and Human Services, the Centers for 23 Disease Control and Prevention, the National 24 Institutes of Health, the Millennium Challenge 25 VerDate Sep 11 2014 01:21 May 25, 2021 Jkt 019200 PO 00000 Frm 00007 Fmt 6652 Sfmt 6201 E:\BILLS\S1451.IS S1451 kjohnson on DSK79L0C42PROD with BILLS 8 •S 1451 IS Corporation, the Peace Corps, the Department 1 of the Treasury, the Office of the Global AIDS 2 Coordinator, the President’s Malaria Initiative, 3 and the United States International Develop- 4 ment Finance Corporation; 5 ‘‘(J) project general levels of resources 6 needed to achieve the objectives stated in the 7 strategy; and 8 ‘‘(K) support the transition to domestic 9 sustainably financed health systems, empha- 10 sizing partnerships that seek to ensure afford- 11 ability, accessibility, quality, and delivery of 12 health services in an equitable and sustainable 13 manner. 14 ‘‘(4) DEVELOPMENT OF STRATEGY.— 15 ‘‘(A) CONSULTATION BY ADMINIS- 16 TRATOR.—The Administrator shall consult with 17 missions of the United States Agency for Inter- 18 national Development in priority countries, civil 19 society, and implementing partner organizations 20 to inform the development of the strategy. 21 ‘‘(B) LOCAL CONSULTATION; SUMMARY.— 22 The missions of the United States Agency for 23 International Development in priority countries 24 shall consult with relevant partner entities and 25 VerDate Sep 11 2014 01:21 May 25, 2021 Jkt 019200 PO 00000 Frm 00008 Fmt 6652 Sfmt 6201 E:\BILLS\S1451.IS S1451 kjohnson on DSK79L0C42PROD with BILLS 9 •S 1451 IS submit to the Coordinator a summary of such 1 consultations to inform the development of the 2 strategy. 3 ‘‘(e) ESTABLISHMENT OF CHILD AND MATERNAL 4 SURVIVAL COORDINATOR.— 5 ‘‘(1) IN GENERAL.—The President should des- 6 ignate an individual, selected from among employees 7 of the United States Agency for International Devel- 8 opment serving in career or noncareer positions in 9 the Senior Executive Service or at the level of a 10 Deputy Assistant Administrator or higher, to serve 11 concurrently as the Child and Maternal Survival Co- 12 ordinator. 13 ‘‘(2) DUTIES.—The Coordinator should— 14 ‘‘(A) oversee— 15 ‘‘(i) the strategy established under 16 subsection (d)(1); and 17 ‘‘(ii) international maternal and child 18 health and nutrition programs, including 19 by representing the United States at inter- 20 national and multilateral maternal and 21 child health and nutrition organizations; 22 ‘‘(B) have primary responsibility for the 23 oversight and coordination of all resources and 24 international activities of the United States 25 VerDate Sep 11 2014 01:21 May 25, 2021 Jkt 019200 PO 00000 Frm 00009 Fmt 6652 Sfmt 6201 E:\BILLS\S1451.IS S1451 kjohnson on DSK79L0C42PROD with BILLS 10 •S 1451 IS Government appropriated or used for inter- 1 national maternal and child health and nutri- 2 tion programs, as determined appropriate by 3 the Administrator; 4 ‘‘(C) direct the budget, planning, and 5 staffing to implement international maternal 6 and child health and nutrition programs for the 7 purpose of ending preventable child and mater- 8 nal deaths; 9 ‘‘(D) lead implementation and revision of 10 the strategy established under subsection (d)(1) 11 beginning 5 years after the date on which the 12 strategy is released; 13 ‘‘(E) coordinate with relevant executive 14 branch agencies, priority countries, and relevant 15 partner entities as appropriate, to carry out the 16 strategy established under subsection (d)(1) 17 and to align current and future investments 18 with high-impact, evidence-based interventions 19 to save lives; 20 ‘‘(F) provide guidance on the design and 21 oversight of grants, contracts, and cooperative 22 agreements with nongovernmental organizations 23 (including community, faith-based, and civil so- 24 ciety organizations) and private sector entities 25 VerDate Sep 11 2014 01:21 May 25, 2021 Jkt 019200 PO 00000 Frm 00010 Fmt 6652 Sfmt 6201 E:\BILLS\S1451.IS S1451 kjohnson on DSK79L0C42PROD with BILLS 11 •S 1451 IS for the purpose of carrying out the strategy es- 1 tablished under subsection (d)(1); and 2 ‘‘(G) report directly to the Administrator 3 regarding implementation of the strategy estab- 4 lished under subsection (d)(1). 5 ‘‘(3) RESTRICTION ON ADDITIONAL OR SUPPLE- 6 MENTAL COMPENSATION.—The Coordinator shall re- 7 ceive no additional or supplemental compensation for 8 carrying out responsibilities and duties under this 9 section. 10 ‘‘(f) AUTHORITY TO ASSIST IN IMPLEMENTATION OF 11 THE STRATEGY.— 12 ‘‘(1) IN GENERAL.—The President may provide 13 assistance to implement the strategy established 14 under subsection (d)(1). 15 ‘‘(2) FOCUS ON IMPACT.— 16 ‘‘(A) TARGETS FOR IMPLEMENTATION RE- 17 QUIRED.—Consistent with the guidelines estab- 18 lished under section 3 of the Foreign Aid 19 Transparency and Accountability Act of 2016 20 (22 U.S.C. 2394c note; Public Law 114–191), 21 the Administrator shall require United States 22 Agency for International Development grants, 23 contracts, and cooperative agreements, for the 24 purposes of the strategy established under sub- 25 VerDate Sep 11 2014 01:21 May 25, 2021 Jkt 019200 PO 00000 Frm 00011 Fmt 6652 Sfmt 6201 E:\BILLS\S1451.IS S1451 kjohnson on DSK79L0C42PROD with BILLS 12 •S 1451 IS section (d)(1), to include targets for implemen- 1 tation of high-impact, evidence-based interven- 2 tions and strengthening health systems, as ap- 3 propriate, including baseline measurements 4 from which to quantify progress. 5 ‘‘(B) EXCEPTION.—In exceptional cir- 6 cumstances for which the Administrator deter- 7 mines that the inclusion of targets described in 8 subparagraph (A) is not reasonable or prac- 9 ticable for a grant, contract, or cooperative 10 agreement, the grant, contract, or cooperative 11 agreement, as the case may be, should include 12 an explanation of the omission and explicitly 13 state how measurable impact will be targeted 14 and tracked. 15 ‘‘(g) ANNUAL REPORTS.— 16 ‘‘(1) REPORTS REQUIRED.—Not later than 1 17 year after the date of the enactment of the Reach 18 Every Mother and Child Act of 2021, and annually 19 thereafter until December 31, 2030, the President 20 shall submit to the appropriate congressional com- 21 mittees a report on progress made to achieve the 22 goals set forth in the strateg [Text truncated for display. 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