Reach Every Mother and Child Act of 2019

II 116TH CONGRESS 1ST SESSION S. 1766 To implement policies to end preventable maternal, newborn, and child deaths globally. IN THE SENATE OF THE UNITED STATES JUNE 10, 2019 Ms. COLLINS (for herself, Mr. COONS, Mr. ROBERTS, Ms. DUCKWORTH, Mr. SULLIVAN, Mr. VAN HOLLEN, Mrs. CAPITO, Mr. MARKEY, Mr. ISAKSON, Mr. MERKLEY, Mr. MORAN, Mr. CARDIN, Mr. CORNYN, Ms. ROSEN, Mr. YOUNG, Ms. STABENOW, Mr. ENZI, Mr. WYDEN, Mr. CRAMER, Mr. MUR- PHY, Mr. RUBIO, and Mr. REED) introduced the following bill; which was read twice and referred to the Committee on Foreign Relations A BILL 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 2019’’. 5 VerDate Sep 11 2014 22:44 Jun 11, 2019 Jkt 089200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6201 E:\BILLS\S1766.IS S1766 kjohnson on DSK79L0C42 with BILLS 2 •S 1766 IS SEC. 2. ASSISTANCE TO END PREVENTABLE MATERNAL, 1 NEWBORN, AND CHILD DEATHS GLOBALLY. 2 The Foreign Assistance Act of 1961 (22 U.S.C. 2151 3 et seq.) is amended by adding at the end of chapter I of 4 part I the following new section: 5 ‘‘SEC. 137. ASSISTANCE TO END PREVENTABLE MATERNAL, 6 NEWBORN, AND CHILD DEATHS GLOBALLY. 7 ‘‘(a) PURPOSE.—The purpose of this section is to im- 8 plement a strategic approach for providing foreign assist- 9 ance in order to end preventable child and maternal deaths 10 globally by 2030. 11 ‘‘(b) DEFINITIONS.—In this section: 12 ‘‘(1) ADMINISTRATOR.—The term ‘Adminis- 13 trator’ means the Administrator of the United 14 States Agency for International Development. 15 ‘‘(2) APPROPRIATE CONGRESSIONAL COMMIT- 16 TEES.—The term ‘appropriate congressional com- 17 mittees’ means— 18 ‘‘(A) the Committee on Foreign Relations 19 and the Committee on Appropriations of the 20 Senate; and 21 ‘‘(B) the Committee on Foreign Affairs 22 and the Committee on Appropriations of the 23 House of Representatives. 24 VerDate Sep 11 2014 22:44 Jun 11, 2019 Jkt 089200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\S1766.IS S1766 kjohnson on DSK79L0C42 with BILLS 3 •S 1766 IS ‘‘(3) COORDINATOR.—The term ‘Coordinator’ 1 means the Child and Maternal Survival Coordinator 2 established under subsection (e). 3 ‘‘(4) INTERNATIONAL MATERNAL AND CHILD 4 HEALTH AND NUTRITION PROGRAMS.—The term 5 ‘international maternal and child health and nutri- 6 tion programs’ means all programs carried out using 7 funds appropriated or otherwise made available for 8 international maternal and child health and nutri- 9 tion that are managed by the United States Agency 10 for International Development Bureau of Global 11 Health. 12 ‘‘(5) RELEVANT PARTNER ENTITIES.—The 13 term ‘relevant partner entities’ means each of the 14 following: 15 ‘‘(A) The governments of other donor 16 countries. 17 ‘‘(B) International financial institutions. 18 ‘‘(C) Nongovernmental organizations. 19 ‘‘(D) Faith-based organizations. 20 ‘‘(E) Professional organizations. 21 ‘‘(F) The private sector. 22 ‘‘(G) Multilateral organizations. 23 ‘‘(H) Local and international civil society 24 groups. 25 VerDate Sep 11 2014 22:44 Jun 11, 2019 Jkt 089200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\S1766.IS S1766 kjohnson on DSK79L0C42 with BILLS 4 •S 1766 IS ‘‘(I) Local health workers. 1 ‘‘(J) International organizations. 2 ‘‘(6) TARGET COUNTRIES.—The term ‘target 3 countries’ means specific countries that have the 4 greatest need and highest burden of child and ma- 5 ternal deaths, taking into consideration countries 6 that— 7 ‘‘(A) have high-need communities in fragile 8 states or conflict-affected states; 9 ‘‘(B) are low- or middle-income countries; 10 or 11 ‘‘(C) are located in regions with weak 12 health systems. 13 ‘‘(c) STATEMENT OF POLICY.—It is the policy of the 14 United States, in partnership with target countries and 15 relevant partner entities, to establish and implement a co- 16 ordinated, integrated, and comprehensive strategy to com- 17 bat the leading causes of maternal, newborn, and child 18 mortality globally and ensure healthy and productive lives 19 by— 20 ‘‘(1) focusing on bringing to scale, specific to 21 each country’s needs, the highest impact, evidence- 22 based interventions, including for the most vulner- 23 able populations, with a focus on country and com- 24 munity ownership; 25 VerDate Sep 11 2014 22:44 Jun 11, 2019 Jkt 089200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\S1766.IS S1766 kjohnson on DSK79L0C42 with BILLS 5 •S 1766 IS ‘‘(2) designing, implementing, monitoring, and 1 evaluating programs in a way that enhances trans- 2 parency and accountability, increases sustainability, 3 and improves outcomes in target countries; and 4 ‘‘(3) supporting the research, development, and 5 introduction of innovative tools and approaches to 6 accelerate progress toward ending preventable child 7 and maternal deaths. 8 ‘‘(d) STRATEGY.— 9 ‘‘(1) IN GENERAL.—Not later than one year 10 after the date of the enactment of the Reach Every 11 Mother and Child Act of 2019, the President shall 12 establish and implement a comprehensive five-year, 13 whole-of-government strategy, together with target 14 countries and donors, to contribute toward the glob- 15 al goal of ending preventable child and maternal 16 deaths by 2030 as a foundation for ensuring healthy 17 and productive lives. 18 ‘‘(2) ELEMENTS.—The strategy established 19 under paragraph (1) shall— 20 ‘‘(A) set outcome-based targets to achieve 21 the goals of the strategy and ascertain baseline 22 data relevant for each target country and for all 23 areas of focus and programming as of the date 24 of the release of the strategy; 25 VerDate Sep 11 2014 22:44 Jun 11, 2019 Jkt 089200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6201 E:\BILLS\S1766.IS S1766 kjohnson on DSK79L0C42 with BILLS 6 •S 1766 IS ‘‘(B) utilize United States Government 1 strategies and frameworks relevant to ending 2 preventable child and maternal deaths, includ- 3 ing specific objectives, programs, and ap- 4 proaches to achieve the highest-impact, evi- 5 dence-based interventions to address the leading 6 causes of death, particularly among the most 7 vulnerable populations, of— 8 ‘‘(i) women related to pregnancy, 9 childbirth, and post-delivery; 10 ‘‘(ii) newborns in their first 28 days; 11 and 12 ‘‘(iii) infants and children under the 13 age of five years old; 14 ‘‘(C) include development and scale up of 15 new technologies and approaches, including 16 those supported by public-private partnerships, 17 for research and innovation; 18 ‘‘(D) promote coordination and efficiency 19 within and amongst the relevant executive 20 branch agencies and initiatives, including the 21 United States Agency for International Devel- 22 opment, the Department of State, the Depart- 23 ment of Health and Human Services, the Cen- 24 ters for Disease Control and Prevention, the 25 VerDate Sep 11 2014 22:44 Jun 11, 2019 Jkt 089200 PO 00000 Frm 00006 Fmt 6652 Sfmt 6201 E:\BILLS\S1766.IS S1766 kjohnson on DSK79L0C42 with BILLS 7 •S 1766 IS National Institutes of Health, the Millennium 1 Challenge Corporation, the Peace Corps, the 2 Department of the Treasury, the Office of the 3 Global AIDS Coordinator, and the President’s 4 Malaria Initiative; 5 ‘‘(E) project general levels of resources 6 needed to achieve the strategy’s stated objec- 7 tives; 8 ‘‘(F) identify strategies for leveraging re- 9 sources in new and innovative ways; 10 ‘‘(G) align with country- and community- 11 driven maternal, newborn, and child health and 12 survival plans and improve coordination with 13 foreign governments and international organiza- 14 tions; 15 ‘‘(H) outline consultations with relevant 16 partner entities as appropriate; 17 ‘‘(I) implement results-based contracting 18 (such as pay-for-success) and financial and 19 operational risk reduction; 20 ‘‘(J) promote a shift towards investments 21 that support inclusive and sustainable business 22 models; and 23 ‘‘(K) support the transition to domestic 24 sustainably financed health systems. 25 VerDate Sep 11 2014 22:44 Jun 11, 2019 Jkt 089200 PO 00000 Frm 00007 Fmt 6652 Sfmt 6201 E:\BILLS\S1766.IS S1766 kjohnson on DSK79L0C42 with BILLS 8 •S 1766 IS ‘‘(3) INITIAL STRATEGY.—For the purposes of 1 this section, a strategy meeting the criteria described 2 in paragraph (2) that is in effect as of the date of 3 enactment of this section may be deemed to fulfill 4 the establishment requirement in paragraph (1). 5 ‘‘(e) ESTABLISHMENT OF CHILD AND MATERNAL 6 SURVIVAL COORDINATOR.— 7 ‘‘(1) IN GENERAL.—The President shall des- 8 ignate a current USAID employee serving in a ca- 9 reer or non-career position in the Senior Executive 10 Service or at the level of a Deputy Assistant Admin- 11 istrator or higher to serve concurrently as the Child 12 and Maternal Survival Coordinator. The Coordinator 13 shall be responsible for— 14 ‘‘(A) overseeing the strategy established 15 under subsection (d); and 16 ‘‘(B) international maternal and child 17 health and nutrition programs. 18 ‘‘(2) DUTIES.—The Coordinator shall— 19 ‘‘(A) have the primary responsibility for 20 the oversight and coordination of all resources 21 and international activities, as determined ap- 22 propriate by the Administrator of the United 23 States Agency for International Development, 24 of the United States Government appropriated 25 VerDate Sep 11 2014 22:44 Jun 11, 2019 Jkt 089200 PO 00000 Frm 00008 Fmt 6652 Sfmt 6201 E:\BILLS\S1766.IS S1766 kjohnson on DSK79L0C42 with BILLS 9 •S 1766 IS or used for international maternal and child 1 health and nutrition programs; 2 ‘‘(B) direct the budget, planning, and 3 staffing to implement international maternal 4 and child health and nutrition programs for the 5 purpose of ending preventable child and mater- 6 nal deaths; 7 ‘‘(C) lead implementation and revision, not 8 less frequently than once every 5 years, of the 9 strategy established under subsection (d)(1); 10 ‘‘(D) coordinate with relevant executive 11 branch agencies, target countries, and relevant 12 partner entities as appropriate, to carry out the 13 strategy established under section 5(a) and to 14 align current and future investments with high- 15 impact, evidence-based interventions to save 16 lives; 17 ‘‘(E) provide guidance on the design and 18 oversight of grants, contracts, and cooperative 19 agreements with nongovernmental organizations 20 (including community, faith-based, and civil so- 21 ciety organizations) and private sector entities 22 for the purpose of carrying out the strategy es- 23 tablished under subsection (d)(1); and 24 VerDate Sep 11 2014 22:44 Jun 11, 2019 Jkt 089200 PO 00000 Frm 00009 Fmt 6652 Sfmt 6201 E:\BILLS\S1766.IS S1766 kjohnson on DSK79L0C42 with BILLS 10 •S 1766 IS ‘‘(F) report directly to the Administrator 1 regarding implementation of the strategy estab- 2 lished under subsection (d)(1). 3 ‘‘(3) RESTRICTION ON ADDITIONAL OR SUPPLE- 4 MENTAL COMPENSATION.—The Coordinator shall re- 5 ceive no additional or supplemental compensation as 6 a result of carrying out responsibilities and duties 7 under this section. 8 ‘‘(f) AUTHORITY TO ASSIST IN IMPLEMENTATION OF 9 THE STRATEGY.— 10 ‘‘(1) IN GENERAL.—The President shall provide 11 assistance to implement the strategy established 12 under subsection (d)(1). 13 ‘‘(2) FOCUS ON IMPACT.— 14 ‘‘(A) TARGETS FOR INCREASED IMPLE- 15 MENTATION REQUIRED.—Consistent with the 16 requirements for foreign assistance programs 17 included in the Foreign Aid Transparency and 18 Accountability Act of 2016 (Public Law 114– 19 119), USAID grants, contracts, and cooperative 20 agreements for the purposes of the strategy es- 21 tablished under subsection (d)(1) shall be re- 22 quired to include targets for increased imple- 23 mentation of high-impact, evidence-based inter- 24 ventions and strengthening health systems, as 25 VerDate Sep 11 2014 01:31 Jun 13, 2019 Jkt 089200 PO 00000 Frm 00010 Fmt 6652 Sfmt 6201 E:\BILLS\S1766.IS S1766 kjohnson on DSK79L0C42 with BILLS 11 •S 1766 IS appropriate, including the establishment of 1 baseline measurements from which to quantify 2 progress. 3 ‘‘(B) EXCEPTION.—In exceptional cir- 4 cumstances where USAID determines that in- 5 clusion of coverage targets or baseline measures 6 are not reasonable or practicable for the grant, 7 contract, or cooperative agreement, the funding 8 mechanism shall include an explanation of the 9 omission and explicitly state how measurable 10 impact will be targeted and tracked. 11 ‘‘(g) REPORTS.— 12 ‘‘(1) REPORT REQUIRED.—Not later than one 13 year after the date of the enactment of this section, 14 and annually thereafter for 5 additional years, the 15 President shall submit to the appropriate congres- 16 sional committees a report on progress made to 17 achieve the strategy established under subsection 18 (d)(1) as well as progress toward the goal to end 19 preventable child and maternal deaths globally. The 20 report shall be made publicly available. 21 ‘‘(2) INFORMATION INCLUDED IN REPORT.— 22 The report required under paragraph (1) shall in- 23 clude the following elements: 24 VerDate Sep 11 2014 22:44 Jun 11, 2019 Jkt 089200 PO 00000 Frm 00011 Fmt 6652 Sfmt 6201 E:\BILLS\S1766.IS S1766 kjohnson on DSK79L0C42 with BILLS 12 •S 1766 IS ‘‘(A) Indicators of progress made by 1 United States Government programs carried 2 out under international maternal and child 3 health and nutrition programs for the purposes 4 of improving maternal, newborn, and child 5 health and survival, particularly among the 6 most vulnerable populations, in each target 7 country and overall, including— 8 ‘‘(i) maternal mortality ratio per 9 100,000 live births and under-5 mortality 10 ratio per 1,000 live births; 11 ‘‘(ii) number of maternal, newborn, 12 and child deaths averted; 13 ‘‘(iii) percentage of births attended by 14 skilled health personnel; 15 ‘‘(iv) an analysis of gaps in the health 16 workforce required to end preventable child 17 and maternal deaths, including an analysis 18 of health workforce density (number of cer- 19 tified health workers, including commu- 20 nity-based health workers, per population); 21 ‘‘(v) a description of the measured or 22 estimated impact on maternal, newborn, 23 and child survival of each ongoing program 24 or project; 25 VerDate Sep 11 2014 22:44 Jun 11, 2019 Jkt 089200 PO 00000 Frm 00012 Fmt 6652 Sfmt 6201 E:\BILLS\S1766.IS S1766 kjohnson on DSK79L0C42 with BILLS 13 •S 1766 IS ‘‘(vi) progress towards achieving the 1 goal to save 15,000,000 children’s lives 2 and 600,000 women’s lives, and any subse- 3 quent goals established under the strate [Text truncated for display. 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