[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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