,,ii #aacth ,,congress #b;d ,session ,s4 #bhec ,,in ,,the ,,senate ,,of ,,the ,,united ,,states ,september #ah1 #bjad ,mr4 ,coons 7for himself1 ,mr4 ,graham1 and ,mr4 ,cardin7 introduced the following bill2 which was read twice and referred to the ,committee on ,foreign ,relations ,a ,,bill ,to implement policies to end preventable maternal1 newborn1 and child deaths globally4 #a4 ,short title ,this ,act may be cited as the ,accelerating ,action in ,maternal and ,child ,health ,act of #bjad4 #b4 ,purpose ,the purpose of this ,act is to provide tools for the ,united ,states ,government to use to accelerate the reduction of preventable maternal1 newborn1 and child deaths in #bd ,united ,states ,agency for ,international ,development 7,,usaid7 focus countries by #bjbj1 saving #ae1jjj1jjj children and #fjj1jjj mothers4 #c4 ,findings ,congress makes the following findings3 7#a7 ,over the past #b decades1 child mortality has reduced by nearly #ej percent and maternal mortality has reduced by #dj percent1 thanks in large part to ,united ,states ,government action and intervention4 7#b7 ,in the last #c years1 #bd priority countries--of which #af are in ,africa--have achieved an #h percent reduction in under-#e mortality1 saving #ejj1jjj lives4 7#c7 ,the report ,acting on the ,call3 ,ending ,preventable ,child and ,maternal ,deaths developed by ,,usaid provides a critical foundation of evidence1 knowledge1 modeling1 and policy development on ending maternal1 newborn1 and child deaths worldwide4 7#d7 ,to achieve ,millennium ,development ,goal #d--to reduce child mortality by #b_/c between #aiij and #bjae--on time1 the global annual rate of reduction in under-#e mortality would need to rise to #ae4f percent from #bjab through #bjae1 much faster than the #c4i percent achieved from #bjje through #bjab4 7#e7 ,according to the ,world ,health ,organization 7,,who71 every year #f1fjj1jjj children under the age of #e--primarily infants--die from preventable or treatable causes1 and more than #hjj women die every day from complications during pregnancy and childbirth4 7#f7 ,the vast majority of these deaths occur in the developing world and countries in ,africa have the highest burden4 7#g7 ,the highest rates of child mortality are still in sub-,saharan ,africa1 with an under-#e mortality rate of #ih deaths per #a1jjj live births--more than #ae times the average for developed regions4 7#h7 ,investing in women and children reduces poverty1 stimulates economic growth1 and most importantly1 saves lives4 7#i7 ,health products1 such as vaccines and treatments1 have contributed significantly to recent successes in child and maternal survival globally4 ,new approaches and technologies are critically needed to accelerate progress toward ending preventable maternal and child deaths4 7#aj7 ,the ,,who identifies the following leading causes of maternal1 newborn1 and child mortality3 7,a7 ,leading causes of maternal mortality in low-income countries include post-partum bleeding1 infection1 and hypertension4 7,b7 ,newborn deaths account for approximately #dd percent of deaths among children under age #e and are predominantly caused by infections1 premature birth1 and asphyxia4 7,c7 ,most deaths of children under the age of #e are a result of preventable causes1 such as respiratory infections 7commonly from pneumonia71 diarrhea1 and malaria4 7,d7 ,malnutrition is the underlying contributing factor in about #de percent of all child deaths1 making children more vulnerable to severe diseases4 #d4 ,statement of policy ,it is the policy of the ,united ,states1 in partnership with host governments1 international financial institutions1 nongovernmental organizations1 faith-based organizations1 and the private sector1 to establish a comprehensive1 coordinated1 integrated strategy to combat the leading causes of maternal1 newborn1 and child mortality globally by-- 7#a7 building on progress and success to date2 7#b7 scaling up the most effective evidence-based interventions with a focus on country ownership2 7#c7 focusing on ,,usaid's #bd priority countries2 7#d7 streamlining existing resources and scaling up increased targeted resources2 7#e7 increasing transparency and accountability2 and 7#f7 creating innovative new public-private financing mechanisms4 #e4 ,strategy 7a7 ,in general ,the ,president shall establish a strategy to accelerate action in each of the #bd priority countries set forth in section #g1 building on the evidence outlined in ,,usaid's ,acting on the ,call3 ,ending ,preventable ,child and ,maternal ,deaths4 ,the strategy will use the current modeling and data that outlines the most proven effective interventions4 ,the strategy shall further strengthen the capability of the ,united ,states to be an effective leader in maternal1 newborn1 and child health1 particularly in ,africa1 and will be a first step toward a broader1 concerted effort to end maternal1 newborn1 and child deaths worldwide4 7b7 ,elements ,the strategy established under subsection 7a7 shall-- 7#a7 include specific objectives1 multisectoral approaches1 and specific strategies to address the leading causes of death among mothers during pregnancy1 childbirth1 and post-delivery2 newborns in their first #bh days2 and children under the age of #e2 7#b7 clarify the responsibilities of the country1 the implementing organization1 and the ,united ,states in the achievement of such objectives2 7#c7 include regular benchmarks to measure1 where appropriate1 progress toward achieving such objectives2 7#d7 utilize data and modeling to implement the most effective interventions for saving #ae1jjj1jjj children and #fjj1jjj mothers2 7#e7 illustrate the result of coordination among relevant executive branch agencies1 foreign governments1 and international organizations2 7#f7 provide projected levels of resources needed to achieve the stated objectives2 7#g7 expand public-private partnerships for research and innovation and for leveraging resources in new and innovative ways2 and 7#h7 use open1 fair1 and competitive procedures wherever appropriate and possible in the administration1 execution1 and evaluation of the program4 7c7 ,targeted services ,the strategy established under subsection 7a7 should focus on the following evidence-based categories of intervention3 7#a7 ,safe motherhood and newborn survival1 including-- 7,a7 prenatal and postnatal care for mothers and newborns2 7,b7 quality care during labor and delivery1 including in emergencies2 and 7,c7 education on healthy timing and spacing of pregnancies4 7#b7 ,healthy households and schools1 including ,water1 ,sanitation1 and ,hygiene 7,,wash74 7#c7 ,nutrition1 including-- 7,a7 maternal and child nutrition during the first #a1jjj days2 and 7,b7 prevention of maternal malnutrition4 7#d7 ,healthy childhood1 including-- 7,a7 vaccines for the leading causes of maternal1 newborn1 and child deaths2 7,b7 prevention and treatment for pneumonia and diarrhea2 7,c7 prevention of mother-to-child transmission of ,,hiv 7,,pmtct72 7,d7 prevention and treatment of malaria2 and 7,e7 capacity-building of health professionals4 #f4 ,establishment of an innovative public-private financing mechanism ,the ,united ,states ,government shall establish a pilot program for innovative financing mechanisms for delivering maternal1 newborn1 and child health interventions in the #bd priority countries set forth in section #g based on the specific recommendations outlined by the convening of high-level global experts at the #bjad ,united ,nations ,general ,assembly4 ,the innovative financing framework will establish a method to mobilize capital for health utilizing tools1 including loans and loan guarantees1 volume guarantees1 development impact bonds1 or partner government taxes1 levies1 fees1 and funds4 #g4 ,priority countries 7a7 ,in general ,based on the global target list developed by ,,usaid1 the priority countries for receiving maternal and child health programming under this ,act are the following3 7#a7 ,afghanistan4 7#b7 ,bangladesh4 7#c7 ,the ,democratic ,republic of the ,congo 7,,drc74 7#d7 ,ethiopia4 7#e7 ,ghana4 7#f7 ,haiti4 7#g7 ,india4 7#h7 ,indonesia4 7#i7 ,kenya4 7#aj7 ,liberia4 7#aa7 ,madagascar4 7#ab7 ,malawi4 7#ac7 ,mali4 7#ad7 ,mozambique4 7#ae7 ,nepal4 7#af7 ,nigeria4 7#ag7 ,pakistan4 7#ah7 ,rwanda4 7#ai7 ,senegal4 7#bj7 ,south ,sudan4 7#ba7 ,tanzania4 7#bb7 ,uganda4 7#bc7 ,yemen4 7#bd7 ,zambia4 7b7 ,eligibility criteria ,the ,united ,states ,government should give preference to applying mechanisms under this ,act to the countries listed under subsection 7a7 that have reached or made progress towards #bjja ,abuja ,declaration commitments involving pledges to increase government funding for health to at least #ae percent within the next #e years4 ,a candidate country should be also considered to be an eligible country by demonstrating a commitment to-- 7#a7 peaceful and democratic governance2 7#b7 civil society engagement2 7#c7 economic freedom2 and 7#d7 investments in the people of such country1 particularly in maternal1 newborn1 and child health4 #h4 ,progress report ,beginning #b years after the date of the enactment of this ,act1 the ,president shall provide an annual progress report to ,congress on activities under this ,act1 including-- 7#a7 data on mechanisms implemented under this ,act1 including a description of how they are designed1 managed1 and monitored and evaluated2 7#b7 how many mechanisms are implemented and where2 and 7#c7 the results of implementation of such mechanisms1 and recommendations for improving these mechanisms to ensure future growth and success4 #i4 ,authorization of appropriations ,there are authorized to be appropriated to carry out this ,act such sums as may be necessary for each of fiscal years #bjae through #bjai1 to remain available until expended4