[Congressional Bills 116th Congress]
[From the U.S. Government Publishing Office]
[S. Res. 119 Introduced in Senate (IS)]
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116th CONGRESS
1st Session
S. RES. 119
Supporting the goals of World Tuberculosis Day to raise awareness about
tuberculosis.
_______________________________________________________________________
IN THE SENATE OF THE UNITED STATES
March 14, 2019
Mr. Brown (for himself and Mr. Sullivan) submitted the following
resolution; which was referred to the Committee on Health, Education,
Labor, and Pensions
_______________________________________________________________________
RESOLUTION
Supporting the goals of World Tuberculosis Day to raise awareness about
tuberculosis.
Whereas \1/4\ of the population of the world is infected with the tuberculosis
bacterium (commonly referred to as ``TB'');
Whereas the World Health Organization (commonly referred to as the ``WHO'')
estimates that 10,000,000 people developed TB in 2017, nine percent of
whom were also infected with the human immunodeficiency virus (commonly
referred to as ``HIV'');
Whereas, in 2017, TB killed an estimated 1,600,000 people, causing more deaths
worldwide than any other single infectious agent;
Whereas \2/3\ of new TB infections in 2017 occurred in India, China, Indonesia,
the Philippines, Pakistan, Nigeria, Bangladesh, and South Africa;
Whereas TB is a leading killer of people infected with HIV, and 300,000 people
with HIV died of TB in 2017;
Whereas additional vulnerable populations at high risk for developing TB include
pregnant women and newborns;
Whereas TB is one of the six leading causes of death among adult women between
the ages of 15 and 49 in low-income countries, and women with TB can
face stigma, discrimination, and in some settings ostracization by their
families and communities;
Whereas the global TB epidemic and the spread of drug-resistant TB present a
persistent public health threat to the United States because the disease
does not recognize borders;
Whereas antibiotic-resistant pathogens are a growing problem worldwide, and
drug-resistant TB can occur when the drugs used to treat TB are misused
or mismanaged;
Whereas studies have demonstrated direct person-to-person transmission of drug-
resistant TB;
Whereas multi-drug resistant TB (commonly referred to as ``MDR-TB'') is caused
by bacteria with resistance to rifampin and isoniazid, the two most
potent treatments for TB infection;
Whereas, according to the 2018 WHO Global Tuberculosis Report, in 2017 an
estimated 3.5 percent of all new TB cases and 18 percent of previously
treated cases were MDR-TB or rifampin-resistant TB;
Whereas, in 2017, an estimated 558,000 people around the world developed MDR-TB
or rifampin-resistant TB, yet only approximately 25 percent of those
individuals have been identified and treated;
Whereas extensively drug-resistant TB (commonly referred to as ``XDR-TB'') is a
rare type of TB that is resistant to nearly all medicines, and therefore
can be very difficult and expensive to treat, especially among patients
with HIV and acquired immune deficiency syndrome (commonly referred to
as ``AIDS'');
Whereas, according to the 2018 WHO Global Tuberculosis Report, in 2017, 127
countries reported at least one case of XDR-TB;
Whereas, in 2017, the Centers for Disease Control and Prevention estimated that
the cost of treating a single patient with MDR-TB in the United States
averaged $164,000, and the average cost of treating a patient with XDR-
TB was even higher at $526,000, compared with $19,000 to treat a patient
with drug-susceptible TB;
Whereas MDR-TB and XDR-TB cases in the United States between 2005 and 2007
collectively cost the health care system an estimated $53,000,000,
according to an analysis by the Centers for Disease Control and
Prevention;
Whereas the Centers for Disease Control and Prevention estimates that costs
resulting from all forms of TB in the United States totaled more than
$460,000,000 in 2017;
Whereas, in a 2000 report, the Institute of Medicine found that a decrease in TB
control funding and the spread of HIV and AIDS caused a resurgence of TB
in the late 1980s and early 1990s;
Whereas a total of 9,105 TB cases were reported in the United States in 2017,
representing all 50 States and the District of Columbia, and up to
13,000,000 people in the United States are estimated to be living with
latent TB infection;
Whereas 75 percent of States have reported an increase in the proportion of
complex cases of TB in recent years due to factors such as homelessness,
HIV infection, drug resistance, substance abuse, refugee status, and
other factors;
Whereas the rate of TB disease in African Americans is eight times higher than
the rate in White non-Hispanic Americans, and significant disparities
exist among other minorities in the United States, including Native
Americans and Alaska Natives, Asian Americans, and Hispanic Americans,
with 86 percent of all reported TB cases in the United States in 2016
occurring in racial or ethnic minorities;
Whereas, globally in 2017, an estimated 1,000,000 children developed TB and
230,000 children died of TB;
Whereas smoking greatly increases the risks of contracting TB and TB recurrence
and impairs the response to treatment;
Whereas diabetes is a major risk factor for TB, and people with diabetes are
more likely to develop TB and have a higher risk of death due to TB;
Whereas bedaquiline is an antibiotic that boosts an MDR-TB patient's chance of
survival from approximately 50 percent to as much as 80 percent, and
through a public-private partnership, the United States Agency for
International Development (commonly referred to as ``USAID'') provided
approximately 30,000 treatments in 110 countries from 2015 through the
end of February 2018;
Whereas Bacillus Calmette-Guerin, a TB vaccine that is known as ``BCG'',
provides some protection to infants and young children but has had
little epidemiologic impact on TB worldwide;
Whereas there is a critical need for new drugs, diagnostics, and vaccines for
controlling the global TB epidemic;
Whereas, in September 2018, the United Nations held the first high-level meeting
on TB in which 120 countries, including the United States, signed a
political declaration committing to accelerating the TB response,
including by increasing funding for TB control programs and research and
development efforts, with the goal of reaching all affected people with
TB prevention and care;
Whereas the enactment of the Tom Lantos and Henry J. Hyde United States Global
Leadership Against HIV/AIDS, Tuberculosis, and Malaria Reauthorization
Act of 2008 (Public Law 110-293; 122 Stat. 2918), and the Comprehensive
Tuberculosis Elimination Act of 2008 (Public Law 110-392; 122 Stat.
4195) provided a historic United States commitment to the global
eradication of TB, including a commitment to treat 4,500,000 TB patients
and 90,000 MDR-TB patients between 2009 and 2013 and to provide
additional treatment through coordinated multilateral efforts;
Whereas USAID--
(1) provides technical assistance to 22 countries highly burdened by TB
to build self-reliance and support the adoption of state-of-the-art TB-
related technologies;
(2) supports the development of new diagnostic and treatment tools; and
(3) supports research to develop new vaccines and other new methods to
combat TB;
Whereas, in 2018, USAID launched--
(1) a new business model entitled ``Global Accelerator to End
Tuberculosis'' to accelerate progress and build self-reliance with respect
to TB prevention and treatment; and
(2) a new mechanism to directly support local organizations in priority
countries;
Whereas TB incidence in the countries that receive bilateral TB funding from the
United States through USAID has decreased by nearly \1/4\ since 2000;
Whereas, according the Copenhagen Consensus Center, TB prevention programs
return $56 for each dollar invested, which is one of the highest returns
on investment of any health intervention;
Whereas the Centers for Disease Control and Prevention, partnering with other
entities of the United States and individual States and territories,
directs the national TB elimination program, coordinates TB
surveillance, technical assistance, and prevention activities, and helps
to support the development of new diagnostic, treatment, and prevention
tools to combat TB;
Whereas the National Institutes of Health, through its many institutes and
centers, plays the leading role in basic and clinical research on the
identification, treatment, and prevention of TB;
Whereas the Global Fund to Fight AIDS, Tuberculosis, and Malaria (commonly
referred to as the ``Global Fund''), to which the United States is a top
financial donor, provides more than 65 percent of all international
financing for TB programs;
Whereas, to date, Global Fund-supported programs have detected and treated more
than 17,400,000 cases of TB; and
Whereas March 24, 2019, is World Tuberculosis Day, a day that commemorates the
date in 1882 on which Dr. Robert Koch announced his discovery of
Mycobacterium tuberculosis, the bacteria that causes TB: Now, therefore,
be it
Resolved, That the Senate--
(1) supports the goals of World Tuberculosis Day to raise
awareness about tuberculosis;
(2) commends the progress of tuberculosis elimination
efforts by entities that include the United States Agency for
International Development, the Centers for Disease Control and
Prevention, the National Institutes of Health, the World Health
Organization, and the Global Fund to Fight AIDS, Tuberculosis,
and Malaria; and
(3) reaffirms the commitment to strengthen the United
States leadership and effectiveness of the global response to
tuberculosis with the goal of ending the tuberculosis epidemic.
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