Sec. 104.13 Population and Health.-(a) FINDINGS.-The Congress recognizes that poor health conditions and uncontrolled population growth can vitiate otherwise successful development efforts.

Large families in developing countries are the result of complex social and economic factors which change relatively slowly among the poor majority least affected by economic progress, as well as the result of a lack of effective birth control. Therefore, effective family planning depends upon economic and social change as well as the delivery of services and is often a matter of political and religious sensitivity. While every country has the right to determine its own policies with respect to population growth, voluntary population planning programs can make a substantial contribution to economic development, higher living standards, and improved health and nutrition.

Good health conditions are a principal element in improved quality of life and contribute to the individual's capacity to participate in the development process, while poor health and debilitating disease can limit productivity.

(b) ASSISTANCE FOR POPULATION PLANNING.-In order to increase the opportunities and motivation for family planning and to reduce the rate of population growth, the President is authorized to furnish assistance, on such terms and conditions as he may determine, for voluntary population planning. In addition to the provision of family planning information and services, including also information and services which relate to and support natural family planning methods, 14 and the conduct of directly relevant demographic research, population planning programs shall emphasize motivation for small families.

(c) ASSISTANCE FOR HEALTH AND DISEASE PREVENTION.-(1)15 In order to contribute to improvements in the health of the greatest number of poor people in developing countries, the President is authorized to furnish assistance, on such terms and conditions as he may determine, for health programs. Assistance under this subsection shall be used primarily for basic integrated health services, safe water and sanitation, disease prevention and control, and related health planning and research. The assistance shall emphasize self-sustaining community-based health programs by means such as training of health auxiliary and other appropriate personnel, support for the establishment and evaluation of projects that can be replicated on a broader scale, measures to improve management of health programs, and other services and suppliers to support health and disease prevention programs.

13 22 U.S.C. 2151b. Sec. 104, as added by sec. 2(3) of the FA Act of 1973 (87 Stat. 715), was amended and restated by sec. 104(a) of the International Development and Food Assistance Act of 1978 (92 Stat. 945). Previous amendments to sec. 104 were made by sec. 4(1) of Public Law 93559 (88 Stat. 1795), sec. 304 of Public Law 94-161 (89 Stat. 857), and sec. 103 of Public Law 95-88 (91 Stat. 534).

14 The words, ", including also information and services which related to and support natural family planning methods," were added by sec. 302(a) of the International Security and Development Cooperation Act of 1980 (Public Law 96-533; 94 Stat. 3145).

15 The paragraph designation "(1)" and a new par. (2) were added by sec. 541(a) of the Foreign Assistance Appropriations Act, 1985, as contained in the Continuing Appropriations Act, 1985 (Public Law 98-473). This amendment had been included as sec. 303 of H.R. 5119, the International Security and Development Cooperation Act of 1984, as passed by the House on May 10, 1984. Section 541(a) enacted sec. 303 of H.R. 5119.

(2)15 (A) In carrying out the purposes of this subsection, the President shall promote, encourage, and undertake activities designed to deal directly with the special health needs of children and mothers. Such activities should utilize simple, available technologies which can significantly reduce childhood mortality, such as improved and expanded immunization programs, oral rehydration to combat diarrhoeal diseases, and education programs aimed at improving nutrition and sanitation and at promoting child spacing. In carrying out this paragraph, guidance shall be sought from knowledgeable health professionals from outside the agency primarily responsible for administering this part. In addition to government-to-government programs, activities pursuant to this paragraph should include support for appropriate activities of the types described in this paragraph which are carried out by international organizations (which may include international organizations receiving funds under chapter 3 of this part) and by private and voluntary organizations, and should include encouragement to other donors to support such types of activities.

(B) In addition to amounts otherwise available for such purpose, there are authorized to be appropriated to the President $25,000,000 for use in carrying out this paragraph. Amounts appropriated under this subparagraph are authorized to remain available until expended. 16

(C) Appropriations pursuant to subparagraph (B) may be referred to as the "Child Survival Fund".

(d) INTEGRATION OF ASSISTANCE PROGRAMS.-(1) Assistance under this chapter shall be administered so as to give particular attention to the interrelationship between (A) population growth, and (B) development and overall improvement in living standards in developing countries, and to the impact of all programs, projects, and activities on population growth. All appropriate activities proposed for financing under this chapter shall be designed to build motivation for smaller families through modification of economic and social conditions supportive of the desire for large families, in programs such as education in and out of school, nutrition, disease control, maternal and child health services, improvements in the status and employment of women, agricultural production, rural development, and assistance to the urban poor, and through community-based development programs which give recognition to people motivated to limit the size of their families." Population planning programs shall be coordinated with other programs aimed at reducing the infant mortality rate, providing better nutrition for pregnant women and infants, and raising the standard of living of the poor.

(2) Since the problems of malnutrition, disease, and rapid population growth are closely related, planning for assistance to be provided under subsections (b) and (c) of this section and under section 103 shall be coordinated to the maximum extent practicable.

16 Foreign Assistance Appropriations Act, 1985 (sec. 101 of the Continuing Appropriations Act, 1985; Public Law 98-473; 98 Stat. 1888), provides the following:

"Child Survival Fund: For necessary expenses to carry out the provisions of the "Child Survival Fund, $25,000,000."

17 The reference to community-based development programs was added by sec. 102(b) of the International Development Cooperation Act of 1979 (Public Law 96-53; 93 Stat. 360).

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(3) Assistance provided under this section shall emphasize lowcost integrated delivery systems for health, nutrition, and family planning for the poorest people, with particular attention to the needs of mothers and young children, using paramedical and auxiliary medical personnel, clinics and health posts, commercial distribution systems, and other modes of community outreach.

(e) RESEARCH AND ANALYSIS.-(1) Health and population research and analysis carried out under this Act shall

(A) be undertaken to the maximum extent practicable in developing countries by developing country personnel, linked as appropriate with private and governmental biomedical research facilities within the United States;

(B) take account of the special needs of the poor people of developing countries in the determination of research priorities; and

(C) make extensive use of field testing to adapt basic research to local conditions.

(2) The President is authorized to study the complex factors affecting population growth in developing countries and to identify factors which might motivate people to plan family size or to space their children.

(f) PROHIBITION ON USE OF FUNDS FOR ABORTIONS AND INVOLUNTARY STERILIZATIONS.-(1) None of the funds made available to carry out this part may be used to pay for the performance of abortions as a method of family planning or to motivate or coerce any person to practice abortions.

(2) None of the funds made available to carry out this part may be used to pay for the performance of involuntary sterilizations as a method of family planning or to coerce or provide any financial incentive to any person to undergo sterilizations.

(3) 18 None of the funds made available to carry out this part may be used to pay for any biomedical research which relates, in whole or in part, to methods of, or the performance of, abortions or involuntary sterilization as a means of family planning.

(g) AUTHORIZATION OF APPROPRIATIONS.-There are authorized to be appropriated to the President, in addition to funds otherwise available for such purposes

(1) $211,000,000 for the fiscal year 1982 and $211,000,000 for the fiscal year 1983 to carry out subsection (b) of this section; and

(2) $133,405,000 for the fiscal year 1982 and $133,405,000 for the fiscal year 1983 to carry out subsec. (c) of this section. Of the funds appropriated for each of the fiscal years 1982 and 1983 to carry out subsection (b) of this section, not less than 16 percent or $38,000,000, whichever amount is less, shall be available only for the United Nations Fund for Population Activities.19

1 Par. (3) was added by sec. 302(b) of the International Security and Development Cooperation Act of 1981 (Public Law 97-113; 95 Stat. 1532).

19 The International Security and Development Assistance Authorizations Act of 1983 (sec. 101(b)(2) of the Further Continuing Appropriations, 1984; Public Law 98-151; 97 Stat. 969) provided an authorization for the fiscal year 1984 of $244,600,000 to carry out sec. 104(b) and $133,400,000 to carry out sec. 104(c). An authorization for fiscal year 1985 was not enacted.

The authorization figures for fiscal years 1982 and 1983 to carry out subsecs. (b) and (c) were added by sec. 302(a) of the International Security and Development Cooperation Act of 1981 Continued

Funds appropriated under this subsection are authorized to remain available until expended.

Sec. 105.20 Education and Human Resources Development.(a) 21 In order to reduce illiteracy, to extend basic education, and to increase manpower training in skills related to development, the President is authorized to furnish assistance on such terms and conditions as he may determine, for education, public administration, and human resource development. There are authorized to be

(Public Law 97-113; 95 Stat. 1532). Authorizations under subsec. (b) in recent years include: Fiscal year 1978-$167,000,000; fiscal year 1979-$224,745,000; fiscal year 1980-$201,000,000; fiscal year 1981-$238,000,000. Authorizations under subsec. (c) in recent years include: Fiscal year 1978-$107,700,000; fiscal year 1979-$148,494,000; fiscal year 1980-$141,000,000; fiscal year 1981-$145,300,000.

Foreign Assistance Appropriations Act, 1985 (sec. 101 of the Continuing Appropriations Act, 1985; Public Law 98-473; 98 Stat. 1884) provides the following:

"Population, Development Assistance; For necessary expenses to carry out the provisions of section 104(b), $290,000,000: Provided, That of this amount the funds provided for loans shall remain available for obligation until September 30, 1986: Provided further, That none of the funds appropriated under this heading may be available for the World Health Organization's Special Program of Research, Development and Research Training in Human Reproduction: Provided further, That not less than $46,000,000 or 16 percent of the amount appropriated under this paragraph, whichever is lower, shall be available only to support the United Nations Fund for Population Activities: Provided further, That none of the funds appropriated under this paragraph may be available to any country which includes as part of its population planning programs involuntary abortion: Provided further, That none of the funds appropriated under this paragraph may be available to any organization which includes as part of its population planning programs involuntary abortion: Provided further, that it is the sense of the House of Representatives to reaffirm its commitment to United States population assistance, as authorized by section 104 of the Foreign Assistance Act of 1961 and as appropriated by the Foreign Assistance and Related Programs Appropriations Act, 1982. It is further the sense of the House of Representatives that United States population assistance shall be administered in accordance with and faithful to these laws as interpreted by AID's 1982 "Policy Paper: Population Assistance" and that no funds shall be denied to multilateral as well as nongovernmental and private and voluntary organizations because of their participation, paid for by funds other than those appropriated by the Congress, in activities conducted in accordance with all applicable United States Federal laws and regulations.

"Health, Development Assistance: For necessary expenses to carry out the provisions of section 104(c), $173,138,000: Provided, That of this amount the funds provided for loans shall remain available for obligation until September 30, 1986: Provided further, That not less than $42,000,000 of the funds appropriated under this paragraph shall be available only for Africa: Provided further, That in addition to amounts otherwise appropriated by this Act to carry out the provisions of section 104(c) there is hereby appropriated $50,000,000, which shall be available only for the delivery of primary and related health care services, and basic health care education (primarily oral rehydration and immunization programs) activities not previously justified to the Committees on Appropriations, with such assistance to be provided through private and voluntary organizations and international organizations wherever appropriate."

In addition to the regular fiscal year 1984 appropriation of $125,000,000 for health provided under the Further Continuing Appropriations Act, 1984 (Public Law 98-151), the Second Supplemental Appropriations Act, 1984 (Public Law 98-396), provided the following additional amounts:

"HEALTH, DEVELOPMENT ASSISTANCE

"For an additional amount for 'Health, development assistance', $7,500,000: Provided, That these funds shall be transferred to 'International disaster assistance': Provided further, That these funds shall remain available until September 30, 1985: Provided further, That these funds shall be used only for assistance for Miskito and other Indian groups in Honduras dislocated or otherwise suffering as a result of the strife in that region, for food, medicine and medical care, clothing, temporary shelter, transportation for supplies and personnel, and similar assistance to alleviate the suffering of such people.

"CENTRAL AMERICA DEMOCRACY, PEACE AND DEVELOPMENT INITIATIVE

"HEALTH

"For an additional amount for 'Health, Development Assistance', $18,000,000."

20 22 U.S.C. 2151c. Sec. 105 was added by sec. 2(3) of the FA Act of 1973.

21 Sec. 305 of Public Law 94-161 (89 Stat. 849) added subsection designation “(a)" and new subsecs. (b) and (c).

appropriated to the President for the purposes of this section, in addition to funds otherwise available for for such purposes, $103,600,000 for the fiscal year 1982 and $103,600,000 for the fiscal year 1983, which are authorized to remain available until expended.22 For each of the fiscal years 1982 and 1983, the President shall use not less than $4,000,000 of the funds made available for the purposes of this section to finance scholarships for undergraduate or professional education in the United States for South African students who are disadvantaged by virtue of legal restrictions on their ability to get an adequate undergraduate or professional education, except that up to $1,000,000 of the funds made available for each such fiscal year under chapter 4 of part II of this Act for southern African regional programs may be used to finance such scholarships in lieu of an equal amount under this section.23

(b) 22 Assistance provided under this section shall be used primarily to expand and strengthen nonformal education methods, especially those designed to improve productive skills of rural families and the urban poor and to provide them with useful information; to increase the relevance of formal education systems to the needs of the poor, especially at the primary level, through reform of curricula, teaching materials, and teaching methods, and improved teacher training; and to strengthen the management capabilities of institutions which enable the poor to participate in development. Assistance under this section shall also be provided for advanced education and training of people of developing countries in such disciplines as are required for planning and implementation of public and private development activities.24

22 The International Security and Development Assistance Authorizations Act of 1983 (sec. 101(b)(2) of the Further Continuing Appropriations, 1984; Public Law 98-151; 97 Stat. 969) provided an authorization for the fiscal year 1984 of $121,477,000 to carry out section 105. An authorization for fiscal year 1985 was not enacted.

The authorization figures for fiscal years 1982 and 1983 were added by sec. 303(a) of the International Security and Development Cooperation Act of 1981 (Public Law 97-113; 95 Stat. 1532). Authorizations for recent years include fiscal year 1975-$92,000,000; fiscal year 1976$89,200,000; fiscal year 1977-$101,800,000; fiscal year 1978-$84,900,000; fiscal year 1979— $126,244,000; fiscal year 1980-$105,000,000; fiscal year 1981-$101,000,000.

Foreign Assistance Appropriations Act, 1985 (sec. 101 of the Continuing Appropriations Act, 1985; Public Law 98-473), provides the following:

"Education and human resources development, Development Assistance; For necessary expenses to carry out the provisions of section 105, $188,833,000 Provided. That of this amount the funds provided for loans shall remain available for obligation until September 30, 1986: Provided further. That $4,000,000 of this amount shall be available only for scholarships for South African students in accordance with the last sentence of section 105(a) of the Foreign Assistance Act of 1961 (as added by title III of the International Security and Development Cooperation Act of 1981)."

In addition to the regular fiscal year 1984 appropriation of $116.477,000 provided under the Further Continuing Appropriations Act, 1984, (Public Law 98-151) to carry out the provisions of sec. 105, the Second Supplemental Appropriations Act, 1984, (Public Law 98-396) provided the following additional amount:

"CENTRAL AMERICA DEMOCRACY, PEACE AND DEVELOPMENT INITIATIVE

"EDUCATION AND HUMAN RESOURCES DEVELOPMENT

"For an additional amount for "Education and human resources development, Development Assistance", $10,000,000: Provided. That of this amount not less than $2,000,000 shall be available only for the International Student Exchange Program."

23 This sentence was added by sec. 303(b) of the International Security and Development Cooperation Act of 1981 (Public Law 97-113; 95 Stat. 1532).

24 This sentence was added by Sec. 103(b) of the International Development Cooperation Act of 1979 (Public Law 96-53; 93 Stat. 360).