[Congressional Bills 106th Congress]
[From the U.S. Government Publishing Office]
[S. 1497 Introduced in Senate (IS)]







106th CONGRESS
  1st Session
                                S. 1497

 To amend the Foreign Assistance Act of 1961 to take steps to control 
           the growing international problem of tuberculosis.


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

                             August 4, 1999

   Mrs. Boxer (for herself, Mr. Smith of Oregon, and Mr. Lautenberg) 
introduced the following bill; which was read twice and referred to the 
                     Committee on Foreign Relations

_______________________________________________________________________

                                 A BILL


 
 To amend the Foreign Assistance Act of 1961 to take steps to control 
           the growing international problem of tuberculosis.

    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 ``International Tuberculosis Control 
Act of 1999''.

 SEC. 2. FINDINGS.

    Congress makes the following findings:
            (1) Since the development of antibiotics in the 1950s, 
        tuberculosis has been largely controlled in the United States 
        and the Western World.
            (2) Due to societal factors, including growing urban decay, 
        inadequate health care systems, persistent poverty, 
        overcrowding, and malnutrition, as well as medical factors, 
        including the HIV/AIDS epidemic and the emergence of multi-drug 
        resistant strains of tuberculosis, tuberculosis has again 
        become a leading and growing cause of adult deaths in the 
        developing world.
            (3) According to the World Health Organization--
                    (A) in 1998, about 1,860,000 people worldwide died 
                of tuberculosis-related illnesses;
                    (B) one-third of the world's total population is 
                infected with tuberculosis; and
                    (C) tuberculosis is the world's leading killer of 
                women between 15 and 44 years old and is a leading 
                cause of children becoming orphans.
            (4) Because of the ease of transmission of tuberculosis, 
        its international persistence and growth pose a direct public 
        health threat to those nations that had previously largely 
        controlled the disease. This is complicated in the United 
        States by the growth of the homeless population, the rate of 
        incarceration, international travel, immigration, and HIV/AIDS.
            (5) With nearly 40 percent of the tuberculosis cases in the 
        United States attributable to foreign-born persons, 
        tuberculosis will never be controlled in the United States 
        until it is controlled abroad.
            (6) The means exist to control tuberculosis through 
        screening, diagnosis, treatment, patient compliance, 
        monitoring, and ongoing review of outcomes.
            (7) Efforts to control tuberculosis are complicated by 
        several barriers, including--
                    (A) the labor intensive and lengthy process 
                involved in screening, detecting, and treating the 
                disease;
                    (B) a lack of funding, trained personnel, and 
                medicine in virtually every nation with a high rate of 
                the disease;
                    (C) the unique circumstances in each country, which 
                requires the development and implementation of country-
                specific programs; and
                    (D) the risk of having a bad tuberculosis program, 
                which is worse than having no tuberculosis program 
                because it would significantly increase the risk of the 
                development of more widespread drug-resistant strains 
                of the disease.
            (8) Eliminating the barriers to the international control 
        of tuberculosis through a well-structured, comprehensive, and 
        coordinated worldwide effort would be a significant step in 
        dealing with the increasing public health problem posed by the 
        disease.

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

    Section 104(c) of the Foreign Assistance Act of 1961 (22 U.S.C. 
2151b(c)) is amended by adding at the end the following:
    ``(4)(A) Congress recognizes the growing international problem of 
tuberculosis and the impact its continued existence has on those 
nations that had previously largely controlled the disease. Congress 
further recognizes that the means exist to control and treat 
tuberculosis, and that it is therefore a major objective of the foreign 
assistance program to control the disease. To this end, Congress 
expects the agency primarily responsible for administering this part--
            ``(i) to coordinate with the World Health Organization, the 
        Centers for Disease Control, the National Institutes of Health, 
        and other organizations toward the development and 
        implementation of a comprehensive tuberculosis control program; 
        and
            ``(ii) to set as a goal the detection of at least 70 
        percent of the cases of infectious tuberculosis, and the cure 
        of at least 85 percent of the cases detected, in those 
        countries in which the agency has established development 
        programs, by December 31, 2010.
    ``(B) There are authorized to be appropriated to the President, 
$60,000,000 for fiscal year 2001 to be used to carry out this 
paragraph. Funds appropriated under this subparagraph are authorized to 
remain available until expended.''.
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