HR 1168 IH

To amend the Foreign Assistance Act of 1961 to provide increased foreign assistance for tuberculosis prevention, treatment, and control.

March 22, 2001

Mr. BROWN of Ohio (for himself, Mrs. MORELLA, Mr. WAXMAN, Mr. ANDREWS, Mr. GANSKE, Ms. MCKINNEY, Mr. BACA, Mr. MORAN of Virginia, Mr. RODRIGUEZ, Mrs. TAUSCHER, Mr. OLVER, Mr. KILDEE, Mrs. CAPPS, Mrs. WILSON, Mr. CARSON of Oklahoma, Mr. CAPUANO, Mr. FROST, Mr. UDALL of Colorado, Mr. LEWIS of Georgia, Mr. GREEN of Texas, Ms. BROWN of Florida, Ms. LOFGREN, Mr. SANDLIN, Mr. RANGEL, Ms. MCCARTHY of Missouri, and Mr. REYES) introduced the following bill; which was referred to the Committee on International Relations

To amend the Foreign Assistance Act of 1961 to provide increased foreign assistance for tuberculosis prevention, treatment, and control.

Be it enacted by the Senate and House of Representatives of the United States of America in Congress assembled,

SECTION 1. SHORT TITLE.

This Act may be cited as the `Stop Tuberculosis (TB) Now Act'.

SEC. 2. FINDINGS.

Congress finds the following:

(1)(A) Tuberculosis is one of the greatest infectious causes of death of adults worldwide, killing 2,000,000 people per year--one person every 15 seconds.

(B) Globally, tuberculosis is the leading cause of death of young women and the leading cause of death of people with HIV/AIDS.

(2) An estimated 8,000,000 individuals develop active tuberculosis each year.

(3) Tuberculosis is spreading as a result of inadequate treatment and it is a disease that knows no national borders.

(4) With over 40 percent of tuberculosis cases in the United States attributable to foreign-born individuals and with the increase in international travel, commerce, and migration, elimination of tuberculosis in the United States depends on efforts to control the disease in developing countries.

(5) The threat that tuberculosis poses for Americans derives from the global spread of tuberculosis and the emergence and spread of strains of multi-drug resistant tuberculosis (MDR-TB).

(6) Up to 50,000,000 individuals may be infected with multi-drug resistant tuberculosis.

(7) In the United States, tuberculosis treatment, normally about $2,000 per patient, skyrockets to as much as $250,000 per patient to treat multi-drug resistant tuberculosis, and treatment may not even be successful.

(8) Multi-drug resistant tuberculosis kills more than one-half of those individuals infected in the United States and other industrialized nations and without access to treatment it is a virtual death sentence in the developing world.

(9) There is a highly effective and inexpensive treatment for tuberculosis. Recommended by the World Health Organization as the best curative method for tuberculosis, this strategy, known as directly observed treatment, short course (DOTS), includes low-cost effective diagnosis, treatment, monitoring, and recordkeeping, as well as a reliable drug supply. A centerpiece of DOTS is observing patients to ensure that they take their medication and complete treatment.

SEC. 3. ASSISTANCE FOR TUBERCULOSIS PREVENTION, TREATMENT, AND CONTROL.

(a) ADDITIONAL PREVENTION, TREATMENT, AND CONTROL- Section 104(c)(7)(A) of the Foreign Assistance Act of 1961 (22 U.S.C. 2151b(c)(7)(A)) is amended--

(1) in clause (i), by adding at the end before the semicolon the following: `, including by expanding the use of the strategy known as directly observed treatment, short course (DOTS) and strategies to address multi-drug resistant tuberculosis (MDR-TB) where appropriate at the local level, particularly in countries with the highest rate of tuberculosis'; and

(2) in clause (ii)--

(A) by inserting after `the cure of at least 85 percent of the cases detected' the following: `by focusing efforts on the use of the directly observed treatment, short course (DOTS) strategy or other internationally accepted primary tuberculosis control strategies'; and

(B)(i) by striking `and the cure' and inserting `the cure'; and

(ii) by adding at the end before the period the following: `, and the reduction of tuberculosis-related deaths by 50 percent, by December 31, 2010'.

(b) FUNDING REQUIREMENT- Section 104(c)(7) of the Foreign Assistance Act of 1961 (22 U.S.C. 2151b(c)(7)) is amended--

(1) by redesignating subparagraph (B) as subparagraph (C); and

(2) by inserting after subparagraph (A) the following:

`(B) In carrying out this paragraph, not less than 75 percent of the amount appropriated pursuant to the authorization of appropriations under subparagraph (D) shall be used for the diagnosis and treatment of tuberculosis or for direct patient services and anti-tuberculosis drugs for at-risk and affected populations utilizing directly observed treatment, short course (DOTS) strategy or other internationally accepted primary tuberculosis control strategies developed in consultation with the World Health Organization (WHO), including the Global Tuberculosis Drug Facility of WHO's Stop TB Partnership.'.

(c) ANNUAL REPORT- Section 104(c)(7) of the Foreign Assistance Act of 1961 (22 U.S.C. 2151b(c)(7)) is amended--

(1) by redesignating subparagraph (C) (as redesignated by this Act) as subparagraph (D); and

(2) by inserting after subparagraph (B) the following:

`(C) In conjunction with the transmission of the annual request for enactment of authorizations and appropriations for foreign assistance programs for each fiscal year, the President shall transmit to Congress a report that contains a summary of all programs, projects, and activities carried out under this paragraph for the preceding fiscal year, including a description of the extent to which such programs, projects, and activities have made progress to achieve the goals described in subparagraph (A)(ii).'.

(d) AUTHORIZATION OF APPROPRIATIONS- Subparagraph (D) of section 104(c)(7) of the Foreign Assistance Act of 1961 (22 U.S.C. 2151b(c)(7)), as redesignated by this Act, is amended by striking `$60,000,000 for each of the fiscal years 2001 and 2002' and inserting `$60,000,000 for fiscal year 2001 and $200,000,000 for fiscal year 2002'.

END