	Introduction

Although a number of U.S. agencies and departments implement global health programs that might improve child survival and maternal health (CS/MH), this report focuses only on CS/MH programs conducted by the U.S. Agency for International Development (USAID) from FY2001 to FY2008. In 2006, an estimated 9.7 million children in that age range died, representing a 60% drop in under-five mortality since 1960. The majority of child deaths occur in developing countries, and almost half of them in Africa. On average, nearly 90% of all child deaths are caused by neonatal infections and five infectious diseases: acute respiratory infections (mostly pneumonia), diarrhea, malaria, measles and HIV/AIDS ( Table 1 ). According to UNICEF, undernutrition is the underlying cause of up to half of these deaths. More than 500,000 women die each year due to pregnancy-related causes, and an additional 15-20 million more suffer debilitating long-term effects, such as obstetric fistula (discussed below). UNICEF estimates that 20% of all maternal deaths are linked to undernutrition and that about 75% of maternal deaths are caused by obstetric complications including hemorrhage, sepsis, hypertensive disorders (mostly eclampsia), prolonged or obstructed labor, and unsafe abortions. Low-cost interventions can prevent and treat the condition. From FY2004 through FY2008, Congress provided $19.7 billion for global HIV/AIDS, TB, and malaria programs. Issues for Congress

Congress has consistently boosted appropriations to USAID's global health programs throughout the Administration of President George W. Bush, though mostly for specific diseases. While most health experts applaud the recent increase in U.S. commitment to countering the global spread of diseases like HIV/AIDS, many remained concerned that other health programs that offer life-saving interventions for women and children are overlooked and underfunded, particularly in sub-Saharan Africa. In addition to proposing an increase in funding for CS/MH programs, some observers urge Congress to boost support for other health issues that affect child survival and maternal health.
Appropriations for child survival and maternal health programs (CS/MH) have grown by about 22% during the tenure of President George W. Bush. Most of that growth occurred in FY2008, when Congress provided $521.9 million for CS/MH programs, up from $361.1 million in FY2001. Although Congress provided support during this time for other global health initiatives that affect CS/MH, such as some $19.7 billion for international programs that prevent and treat human immunodeficiency virus/ acquired immunodeficiency syndrome (HIV/AIDS), tuberculosis (TB), and malaria, other global health interventions are discussed only as they relate to USAID's CS/MH programs.
According to latest estimates, 9.7 million children under the age of five died in 2006; some 26,000 each day. The majority of those deaths occurred in developing countries, and almost half of them in Africa. On average, nearly 90% of all child deaths are caused by neonatal infections and five other diseases: acute respiratory infections (primarily pneumonia), diarrhea, malaria, measles, and HIV/AIDS. Undernutrition contributes to more than half of these deaths.
More than 500,000 women die each year due to pregnancy-related causes, and many more suffer debilitating long-term effects, such as obstetric fistula. Most of these deaths occur in developing countries. About 20% of global maternal deaths are linked to undernutrition, and about 75% result from obstetric complications, most often hemorrhage, sepsis, eclampsia, and prolonged or obstructed labor.
While most health experts applaud the recent increase in U.S. commitment to global health, many remain concerned that funding is largely aimed at specific diseases, such as HIV/AIDS and malaria. Other health programs that offer life-saving interventions for women and children are overlooked and underfunded, they contend, particularly in sub-Saharan Africa. In addition to proposing an increase in funding for CS/MH programs, some observers urge Congress to boost support for health systems so that countries can better address a wide range of health issues that affect child survival and maternal health. This report will be updated at the end of the 110th Congress.