[Congressional Bills 107th Congress]
[From the U.S. Government Publishing Office]
[S. 2045 Introduced in Senate (IS)]







107th CONGRESS
  2d Session
                                S. 2045

 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

                             March 21, 2002

    Mrs. Boxer (for herself and Mr. Smith of Oregon) 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 2002''.

SEC. 2. FINDINGS.

    Congress finds that:
            (1) Tuberculosis is a great health and economic burden to 
        impoverished nations and a health and security threat to the 
        United States and other industrialized countries.
            (2) Tuberculosis kills 2,000,000 people each year (a person 
        every 15 seconds) and is second only to HIV/AIDS as the 
        greatest infectious killer of adults worldwide.
            (3) Tuberculosis is today the leading killer of women of 
        reproductive age and of people who are HIV-positive.
            (4) One-third of the world's population is currently 
        infected with the tuberculosis bacterium, including 10,000,000 
        through 15,000,000 persons in the United States, and someone in 
        the world is newly infected with tuberculosis every second.
            (5) With 46 percent of tuberculosis cases in the United 
        States in the year 2000 found in foreign-born persons, as 
        compared to 24 percent in 1990, it is clear that the only way 
        to control tuberculosis in the United States is to control it 
        worldwide.
            (6) Left untreated, a person with active tuberculosis can 
        infect an average of 10 through 15 people in one year.
            (7) Pakistan and Afghanistan are among the 22 countries 
        identified by the World Health Organization as having the 
        highest tuberculosis burden globally.
            (8) More than one-quarter of all adult deaths in Pakistan 
        are due to tuberculosis, and Afghan refugees entering Pakistan 
        have very high rates of tuberculosis, with refugee camps, in 
        particular, being areas where tuberculosis runs rampant.
            (9) The tuberculosis and AIDS epidemics are inextricably 
        linked. Tuberculosis is the first manifestation of AIDS in more 
        than 50 percent of cases in developing countries and is 
        responsible for 40 percent or more of deaths of people with 
        AIDS worldwide.
            (10) An effective, low-cost cure exists for tuberculosis: 
        Directly Observed Treatment Short-course or DOTS. Expansion of 
        DOTS is an urgent global priority.
            (11) DOTS is one of the most cost-effective health 
        interventions available today. A full course of DOTS drugs 
        costs as little as US$10 in low-income countries.
            (12) Proper DOTS treatment is imperative to prevent the 
        development of dangerous multidrug resistant tuberculosis (MDR-
        TB) that arises through improper or incomplete tuberculosis 
        treatment.
            (13) The Global Fund to fight AIDS, Tuberculosis, and 
        Malaria is an important new global partnership established to 
        combat these 3 infectious diseases that together kill 6,000,000 
        people a year. Expansion of effective tuberculosis treatment 
        programs should constitute a major component of Global Fund 
        investment.

SEC. 3. DEFINITIONS.

    In this Act:
            (1) DOTS.--The term ``DOTS'' or ``Directly Observed 
        Treatment Short-course'' means the World Health Organization-
        recommended strategy for treating standard tuberculosis.
            (2) Global alliance for tuberculosis drug development.--The 
        term ``Global Alliance for Tuberculosis Drug Development'' 
        means the public-private partnership that brings together 
        leaders in health, science, philanthropy, and private industry 
        to devise new approaches to tuberculosis and to ensure that new 
        medications are available and affordable in high tuberculosis 
        burden countries and other affected countries.
            (3) Global plan to stop tuberculosis.--The term ``Global 
        Plan to Stop Tuberculosis'' means the plan developed jointly by 
        the Stop Tuberculosis Partnership Secretariat and Partners in 
        Health that lays out what needs to be done to control and 
        eliminate tuberculosis.
            (4) Global tuberculosis drug facility.--The term ``Global 
        Tuberculosis Drug Facility (GDF)'' means the new initiative of 
        the Stop Tuberculosis Partnership to increase access to high-
        quality tuberculosis drugs to facilitate DOTS expansion.
            (5) Stop tuberculosis partnership.--The term ``Stop 
        Tuberculosis Partnership'' means the partnership of the World 
        Health Organization, donors including the United States, high 
        tuberculosis burden countries, multilateral agencies, and 
        nongovernmental and technical agencies committed to short- and 
        long-term measures required to control and eventually eliminate 
        tuberculosis as a public health problem in the world.

 SEC. 4. 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:
            ``(7)(A) Congress recognizes the growing international 
        problem of tuberculosis and the impact its continued existence 
        has on those countries that had previously largely controlled 
        the disease. Congress further recognizes that the means exist 
        to control and treat tuberculosis by implementing the Global 
        Plan to Stop Tuberculosis and by adequately investing in newly 
        created mechanisms, including the Global Tuberculosis Drug 
        Facility, 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 
                with respect to 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, 
                by December 31, 2005, in those countries classified by 
                the World Health Organization as among the highest 
                tuberculosis burden, and by December 31, 2010, in all 
                countries in which the agency has established 
                development programs.
            ``(B)(i) There is authorized to be appropriated 
        $200,000,000 for each of the fiscal years 2003 through 2005 for 
        carrying out this paragraph.
            ``(ii) Funds appropriated under this paragraph are 
        authorized to remain available until expended.
            ``(C) In carrying out subparagraph (A), not less than 75 
        percent of the amount authorized to be appropriated under 
        subparagraph (B) shall be expended for antituberculosis drugs, 
        supplies, patient services, and training in diagnosis and care, 
        in order to increase directly observed treatment shortcourse 
        (DOTS) coverage, including funding for the Global Tuberculosis 
        Drug Facility.
            ``(D) In carrying out subparagraph (A), of the amount 
        authorized to be appropriated under subparagraph (B)--
                    ``(i) not less than 10 percent shall be used for 
                funding of the Global Tuberculosis Drug Facility;
                    ``(ii) not less than 7.5 percent shall be used for 
                funding of the Stop Tuberculosis Partnership; and
                    ``(iii) not less than 2.5 percent shall be used for 
                funding of the Global Alliance for Tuberculosis Drug 
                Development.
            ``(E) The President shall submit a report to Congress 
        annually specifying the increases in the number of people 
        treated and the increases in number of tuberculosis patients 
        cured through each program, project, or activity receiving 
        United States foreign assistance for tuberculosis control 
        purposes.''.
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