Reach Every Mother and Child Act of 2023

II 118TH CONGRESS 1ST SESSION S. 1547 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 MAY 10, 2023 Ms. COLLINS (for herself, Mr. COONS, Mr. WICKER, and Mr. DURBIN) intro- duced the following bill; which was read twice and referred to the Com- mittee 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 2023’’. 5 VerDate Sep 11 2014 02:01 May 20, 2023 Jkt 039200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6201 E:\BILLS\S1547.IS S1547 kjohnson on DSK79L0C42PROD with BILLS 2 •S 1547 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. 138. 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 02:01 May 20, 2023 Jkt 039200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\S1547.IS S1547 kjohnson on DSK79L0C42PROD with BILLS 3 •S 1547 IS ‘‘(3) COORDINATOR.—The term ‘Coordinator’ 1 means the Child and Maternal Survival Coordinator 2 designated 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 Bureau for Global 10 Health, missions, or other operating units of the 11 United States Agency for International Develop- 12 ment. 13 ‘‘(5) MOST VULNERABLE POPULATIONS.—The 14 term ‘most vulnerable populations’ includes adoles- 15 cents, populations in conflict-affected or fragile 16 areas, indigenous populations, religious minorities, 17 individuals with disabilities, and the poorest quintile 18 in urban and remote locations. 19 ‘‘(6) PRIORITY COUNTRIES.—The term ‘priority 20 countries’ means countries that have the greatest 21 need and highest burden of child and maternal 22 deaths, taking into consideration countries that— 23 ‘‘(A) have high-need communities in fragile 24 states or conflict-affected states; 25 VerDate Sep 11 2014 02:01 May 20, 2023 Jkt 039200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\S1547.IS S1547 kjohnson on DSK79L0C42PROD with BILLS 4 •S 1547 IS ‘‘(B) are low- or middle-income countries; 1 or 2 ‘‘(C) are located in regions with weak 3 health systems. 4 ‘‘(7) RELEVANT PARTNER ENTITIES.—The 5 term ‘relevant partner entities’ means each of the 6 following: 7 ‘‘(A) The governments of other donor 8 countries. 9 ‘‘(B) International financial institutions. 10 ‘‘(C) Nongovernmental organizations. 11 ‘‘(D) Faith-based organizations. 12 ‘‘(E) Professional organizations. 13 ‘‘(F) The private sector. 14 ‘‘(G) Multilateral organizations. 15 ‘‘(H) Local and international civil society 16 groups. 17 ‘‘(I) Local health workers. 18 ‘‘(J) International organizations. 19 ‘‘(c) STATEMENT OF POLICY.—It is the policy of the 20 United States, in partnership with priority countries and 21 relevant partner entities, to establish and implement a co- 22 ordinated, integrated, and comprehensive strategy to end 23 preventable child and maternal deaths and ensure healthy 24 and productive lives by— 25 VerDate Sep 11 2014 02:01 May 20, 2023 Jkt 039200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\S1547.IS S1547 kjohnson on DSK79L0C42PROD with BILLS 5 •S 1547 IS ‘‘(1) focusing on bringing to scale the highest- 1 impact, evidence-based interventions that address 2 the leading causes of maternal, newborn, and child 3 mortality in each priority country; 4 ‘‘(2) ensuring equitable access to essential 5 health services for the most vulnerable populations, 6 with a focus on country and community ownership; 7 ‘‘(3) designing, implementing, monitoring, and 8 evaluating programs in a manner that enhances 9 transparency and accountability, increases sustain- 10 ability, and improves outcomes in priority countries; 11 and 12 ‘‘(4) supporting the research, development, and 13 introduction of innovative tools and approaches to 14 accelerate progress toward ending preventable child 15 and maternal deaths. 16 ‘‘(d) STRATEGY.— 17 ‘‘(1) IN GENERAL.—Not later than 1 year after 18 the date of the enactment of the Reach Every Moth- 19 er and Child Act of 2023, the President shall estab- 20 lish and implement a comprehensive 5-year strategy 21 (in this subsection referred to as the ‘strategy’) to 22 contribute toward the global goal of ending prevent- 23 able child and maternal deaths by 2030 as a founda- 24 tion for ensuring healthy and productive lives. 25 VerDate Sep 11 2014 02:01 May 20, 2023 Jkt 039200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6201 E:\BILLS\S1547.IS S1547 kjohnson on DSK79L0C42PROD with BILLS 6 •S 1547 IS ‘‘(2) LEADERSHIP.—The Administrator, in co- 1 ordination with priority countries and relevant part- 2 ner entities, shall lead the establishment and imple- 3 mentation of the strategy. 4 ‘‘(3) CRITERIA.—The strategy shall— 5 ‘‘(A) identify priority countries in which 6 the United States Agency for International De- 7 velopment will implement international mater- 8 nal and child health and nutrition programs to 9 reduce maternal, newborn, and child mortality 10 and improve health outcomes; 11 ‘‘(B) with respect to each priority country, 12 identify the most significant barriers to mater- 13 nal, newborn, and child survival and establish 14 outcome-based targets from which progress to- 15 ward addressing those barriers through inter- 16 national maternal and child health and nutri- 17 tion programs can be tracked; 18 ‘‘(C) in coordination with relevant partner 19 entities, outline how the United States Agency 20 for International Development will implement 21 the highest-impact, evidence-based interventions 22 for reducing maternal, newborn, and child mor- 23 tality and expand access to quality services 24 through community-based approaches to achieve 25 VerDate Sep 11 2014 02:01 May 20, 2023 Jkt 039200 PO 00000 Frm 00006 Fmt 6652 Sfmt 6201 E:\BILLS\S1547.IS S1547 kjohnson on DSK79L0C42PROD with BILLS 7 •S 1547 IS the outcome-based targets established under 1 subparagraph (B); 2 ‘‘(D) promote investments in community- 3 based activities that empower women, support 4 voluntarism, and provide respectful maternity 5 care; 6 ‘‘(E) describe how the most vulnerable 7 populations in each priority country will be tar- 8 geted and reached with highest-impact, evi- 9 dence-based interventions to reduce maternal, 10 newborn, and child mortality; 11 ‘‘(F) use United States Government strate- 12 gies and frameworks relevant to improving ma- 13 ternal, newborn, and child health; 14 ‘‘(G) address backsliding on access to and 15 demand for essential health services and other 16 key challenges affecting maternal, newborn, and 17 child survival caused by the COVID–19 pan- 18 demic; 19 ‘‘(H) include development and scale-up of 20 new technologies and approaches, including 21 those supported by public-private partnerships, 22 for research and innovation; 23 ‘‘(I) promote coordination and efficiency 24 within and among the relevant executive branch 25 VerDate Sep 11 2014 02:01 May 20, 2023 Jkt 039200 PO 00000 Frm 00007 Fmt 6652 Sfmt 6201 E:\BILLS\S1547.IS S1547 kjohnson on DSK79L0C42PROD with BILLS 8 •S 1547 IS agencies and initiatives, including the United 1 States Agency for International Development, 2 the Department of State, the Department of 3 Health and Human Services, the Centers for 4 Disease Control and Prevention, the National 5 Institutes of Health, the Millennium Challenge 6 Corporation, the Peace Corps, the Department 7 of the Treasury, the Office of the Global AIDS 8 Coordinator, the President’s Malaria Initiative, 9 and the United States International Develop- 10 ment Finance Corporation; 11 ‘‘(J) project general levels of resources 12 needed to achieve the objectives stated in the 13 strategy; and 14 ‘‘(K) support the transition to domestic 15 sustainably financed health systems, empha- 16 sizing partnerships that seek to ensure afford- 17 ability, accessibility, quality, and delivery of 18 health services in an equitable and sustainable 19 manner. 20 ‘‘(4) DEVELOPMENT OF STRATEGY.— 21 ‘‘(A) CONSULTATION BY ADMINIS- 22 TRATOR.—The Administrator shall consult with 23 missions of the United States Agency for Inter- 24 national Development in priority countries, civil 25 VerDate Sep 11 2014 02:01 May 20, 2023 Jkt 039200 PO 00000 Frm 00008 Fmt 6652 Sfmt 6201 E:\BILLS\S1547.IS S1547 kjohnson on DSK79L0C42PROD with BILLS 9 •S 1547 IS society, and implementing partner organizations 1 to inform the development of the strategy. 2 ‘‘(B) LOCAL CONSULTATION; SUMMARY.— 3 The missions of the United States Agency for 4 International Development in priority countries 5 shall consult with relevant partner entities and 6 submit to the Coordinator a summary of such 7 consultations to inform the development of the 8 strategy. 9 ‘‘(5) INITIAL STRATEGY.—A strategy meeting 10 the criteria described in paragraph (3) that is in ef- 11 fect as of the date of the enactment of the Reach 12 Every Mother and Child Act of 2023 is deemed to 13 fulfill the establishment requirement under para- 14 graph (1). 15 ‘‘(e) ESTABLISHMENT OF CHILD AND MATERNAL 16 SURVIVAL COORDINATOR.— 17 ‘‘(1) IN GENERAL.—The President shall des- 18 ignate an individual, selected from among employees 19 of the United States Agency for International Devel- 20 opment serving in career or noncareer positions in 21 the Senior Executive Service or at the level of a 22 Deputy Assistant Administrator or higher, to serve 23 concurrently as the Child and Maternal Survival Co- 24 ordinator. 25 VerDate Sep 11 2014 02:01 May 20, 2023 Jkt 039200 PO 00000 Frm 00009 Fmt 6652 Sfmt 6201 E:\BILLS\S1547.IS S1547 kjohnson on DSK79L0C42PROD with BILLS 10 •S 1547 IS ‘‘(2) DUTIES.—The Coordinator shall— 1 ‘‘(A) oversee— 2 ‘‘(i) the strategy established under 3 subsection (d)(1); and 4 ‘‘(ii) international maternal and child 5 health and nutrition programs, including 6 by representing the United States at inter- 7 national and multilateral maternal and 8 child health and nutrition organizations; 9 ‘‘(B) have primary responsibility for the 10 oversight and coordination of all resources and 11 international activities of the United States 12 Government appropriated or used for inter- 13 national maternal and child health and nutri- 14 tion programs, as determined appropriate by 15 the Administrator; 16 ‘‘(C) direct the budget, planning, and 17 staffing to implement international maternal 18 and child health and nutrition programs for the 19 purpose of ending preventable child and mater- 20 nal deaths; 21 ‘‘(D) lead implementation and revision of 22 the strategy established under subsection (d)(1) 23 beginning 5 years after the date on which the 24 strategy is released; 25 VerDate Sep 11 2014 02:01 May 20, 2023 Jkt 039200 PO 00000 Frm 00010 Fmt 6652 Sfmt 6201 E:\BILLS\S1547.IS S1547 kjohnson on DSK79L0C42PROD with BILLS 11 •S 1547 IS ‘‘(E) coordinate with relevant executive 1 branch agencies, priority countries, and relevant 2 partner entities as appropriate, to carry out the 3 strategy established under subsection (d)(1) 4 and to align current and future investments 5 with high-impact, evidence-based interventions 6 to save lives; 7 ‘‘(F) provide guidance on the design and 8 oversight of grants, contracts, and cooperative 9 agreements with nongovernmental organizations 10 (including community, faith-based, and civil so- 11 ciety organizations) and private sector entities 12 for the purpose of carrying out the strategy es- 13 tablished under subsection (d)(1); and 14 ‘‘(G) report directly to the Administrator 15 regarding implementation of the strategy estab- 16 lished under subsection (d)(1). 17 ‘‘(3) RESTRICTION ON ADDITIONAL OR SUPPLE- 18 MENTAL COMPENSATION.—The Coordinator shall re- 19 ceive no additional or supplemental compensation for 20 carrying out responsibilities and duties under this 21 section. 22 ‘‘(f) AUTHORITY TO ASSIST IN IMPLEMENTATION OF 23 THE STRATEGY.— 24 VerDate Sep 11 2014 02:01 May 20, 2023 Jkt 039200 PO 00000 Frm 00011 Fmt 6652 Sfmt 6201 E:\BILLS\S1547.IS S1547 kjohnson on DSK79L0C42PROD with BILLS 12 •S 1547 IS ‘‘(1) IN GENERAL.—The President may provide 1 assistance to implement the strategy established 2 under subsection (d)(1). 3 ‘‘(2) FOCUS ON IMPACT.— 4 ‘‘(A) TARGETS FOR IMPLEMENTATION RE- 5 QUIRED.—Consistent with the guidelines estab- 6 lished under section 3 of the Foreign Aid 7 Transparency and Accountability Act of 2016 8 (22 U.S.C. 2394c note; Public Law 114–191), 9 the Administrator shall require United States 10 Agency for International Development grants, 11 contracts, and cooperative agreements, for the 12 purposes of the strategy established under sub- 13 section (d)(1), to include targets for implemen- 14 tation of high-impact, evidence-based interven- 15 tions and strengthening health systems, as ap- 16 propriate, including baseline measurements 17 from which to quantify progress. 18 ‘‘(B) EXCEPTION.—In exceptional cir- 19 cumstances for which the Administrator deter- 20 mines that the inclusion of targets described in 21 subparagraph (A) is not reasonable or prac- 22 ticable for a grant, contract, or cooperative 23 agreement, the grant, contract, or cooperative 24 agreement, as the case may be, shall include an 25 VerDate Sep 11 2014 02:01 May 20, 2023 Jkt 039200 PO 00000 Frm 00012 Fmt 6652 Sfmt 6201 E:\BILLS\S1547.IS S1547 kjohnson on DSK79L0C42PROD with BILLS 13 •S 1547 IS explanation o [Text truncated for display. 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