[Congressional Bills 108th Congress]
[From the U.S. Government Publishing Office]
[H.R. 2069 Introduced in House (IH)]







108th CONGRESS
  1st Session
                                H. R. 2069

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


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                              May 13, 2003

     Mr. Brown of Ohio (for himself and Mrs. Wilson of New Mexico) 
 introduced the following bill; which was referred to the Committee on 
International Relations, and in addition to the Committee on Energy and 
Commerce, for a period to be subsequently determined by the Speaker, in 
   each case for consideration of such provisions as fall within the 
                jurisdiction of the committee concerned

_______________________________________________________________________

                                 A BILL


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

    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 a great health and economic burden 
        to impoverished nations and a health and security threat to the 
        United States and other industrialized countries.
            (B) Tuberculosis is one of the greatest infectious causes 
        of death of adults worldwide, killing nearly 2,000,000 people 
        per year--one person every 15 seconds.
            (2) An estimated 8,000,000 individuals develop active 
        tuberculosis each year.
            (3) Today, tuberculosis is the leading killer of women of 
        reproductive age and of people who are HIV-positive.
            (4) Tuberculosis is spreading as a result of inadequate 
        treatment and is a disease that knows no national borders.
            (5) With over 50 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.
            (6) 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).
            (7) Up to 50,000,000 individuals may be infected with 
        multi-drug resistant tuberculosis.
            (8) In the United States, tuberculosis treatment, normally 
        about $2,000 per patient, increases to as much as $1,000,000 
        per patient to treat multi-drug resistant tuberculosis, and 
        treatment may not even be successful.
            (9) Without access to treatment, multi-drug resistant 
        tuberculosis is a virtual death sentence.
            (10) There is a highly effective and inexpensive treatment 
        for standard tuberculosis. Recommended by the World Health 
        Organization (WHO) as the best curative method for 
        tuberculosis, this strategy, known as DOTS (Directly Observed 
        Treatment Short-course), includes low-cost effective diagnosis, 
        treatment, monitoring, and record keeping, as well as a 
        reliable drug supply. A centerpiece of DOTS is observing 
        patients to ensure that they take their medication and complete 
        treatment.
            (11) DOTS is one of the most cost-effective health 
        interventions available today. A full course of DOTS drugs 
        costs as little as $10 in low-income countries.
            (12) Proper DOTS treatment is imperative to prevent the 
        development of dangerous multi-drug resistant tuberculosis that 
        arises through improper or incomplete tuberculosis treatment.
            (13) Building upon the DOTS strategy, DOTS-Plus is a 
        comprehensive tuberculosis management strategy that works as a 
        supplement to the standard DOTS strategy to address areas where 
        there is high prevalence of multi-drug resistant tuberculosis.
            (14) 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 constitutes a major component of Global Fund 
        investment, along with integrated efforts to address HIV and 
        tuberculosis in areas of high prevalence.
            (15) The Centers for Disease Control and Prevention (CDC) 
        is actively involved with global tuberculosis control efforts 
        since the global tuberculosis epidemic directly impacts 
        tuberculosis in the United States, and because Congress has 
        strongly urged the CDC each year to increase its involvement 
        with international tuberculosis control efforts.
            (16) The CDC is assisting countries with a high burden of 
        tuberculosis--
                    (A) to implement the World Health Organization-
                recommended control strategies, DOTS and DOTS-Plus;
                    (B) to identify and treat persons with multi-drug 
                resistant tuberculosis; and
                    (C) to conduct research to identify new 
                diagnostics, treatments, and interventions to control 
                tuberculosis.

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

    (a) Amendment to Foreign Assistance Act of 1961.--Chapter 1 of part 
I of the Foreign Assistance Act of 1961 (22 U.S.C. 2151 et seq.) is 
amended by inserting after section 104 the following new section:

``SEC. 104A. ASSISTANCE FOR TUBERCULOSIS PREVENTION, TREATMENT, AND 
              CONTROL.

    ``(a) Statement of Policy.--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.
    ``(b) Assistance.--
            ``(1) In general.--In meeting the objective described in 
        subsection (a), the President shall provide assistance for the 
        prevention, treatment, and control of tuberculosis.
            ``(2) Additional requirements.--In carrying out paragraph 
        (1), the President shall--
                    ``(A) coordinate with the World Health Organization 
                (WHO), the Global Fund to Fight AIDS, Tuberculosis and 
                Malaria, the Department of Health and Human Services 
                (including Centers for Disease Control and Prevention 
                and the National Institutes of Health), and other 
                organizations with respect to the development and 
                implementation of a comprehensive tuberculosis control 
                program;
                    ``(B) set as a goal the detection of at least 70 
                percent of the cases of infectious tuberculosis, the 
                cure of at least 85 percent of the cases detected by 
                focusing efforts on the use of the Directly Observed 
                Treatment Short-course (DOTS) strategy or other 
                internationally accepted primary tuberculosis control 
                strategies, in those countries in which the United 
                States Agency for International Development has 
                established development programs, by December 31, 2010, 
                and the reduction of tuberculosis-related deaths by 50 
                percent, by December 31, 2010; and
                    ``(C) give priority to activities that increase 
                Directly Observed Treatment Short-course (DOTS) 
                coverage and treatment of multi-drug resistant 
                tuberculosis where needed using DOTS-Plus, including 
                funding for the Global Tuberculosis Drug Facility, the 
                Stop Tuberculosis Partnership, and the Global Alliance 
                for TB Drug Development.
    ``(c) Allocation of Funds.--In carrying out subsection (b), the 
President shall ensure that--
            ``(1) not less than 75 percent of the amount made available 
        to carry out this section for a fiscal year shall be expended 
        for antituberculosis drugs, supplies, direct patient services, 
        and training in diagnosis and treatment for Directly Observed 
        Treatment Short-course (DOTS) coverage and treatment of multi-
        drug resistant tuberculosis using DOTS-Plus; and
            ``(2) not less than 10 percent of the amount made available 
        to carry out this section for a fiscal year shall be expended 
        to provide a United States contribution to the Global 
        Tuberculosis Drug Facility.
    ``(d) Annual Report.--Not later than January 31 of each year, the 
President shall transmit to the appropriate congressional committees a 
report that contains a summary of all programs, projects, and 
activities carried out under this section for the preceding fiscal 
year, including a description of the increase in the number of 
individuals treated and cured through each program, project, and 
activity.
    ``(e) Authorization of Appropriations.--
            ``(1) In general.--There are authorized to be appropriated 
        to the President to carry out this section $200,000,000 for 
        each of the fiscal years 2004 and 2005.
            ``(2) Availability.--Amounts appropriated pursuant to the 
        authorization of appropriations under paragraph (1) are 
        authorized to remain available until expended.
    ``(f) Definitions.--In this section:
            ``(1) Appropriate congressional committees.--The term 
        `appropriate congressional committees' means the Committee on 
        International Relations of the House of Representatives and the 
        Committee on Foreign Relations of the Senate.
            ``(2) DOTS.--The term `DOTS' or `Directly Observed 
        Treatment Short-course' means the World Health Organization-
        recommended strategy for treating tuberculosis.
            ``(3) DOTS-plus.--The term `DOTS-Plus' means a 
        comprehensive tuberculosis management strategy that is built 
        upon and works as a supplement to the standard DOTS strategy, 
        and which takes into account specific issues (such as use of 
        second line anti-tuberculosis drugs) that need to be addressed 
        in areas where there is high prevalence of multi-drug resistant 
        tuberculosis.
            ``(4) 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 ensure that new medications are available and affordable in 
        high tuberculosis burden countries and other affected 
        countries.
            ``(5) 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.
            ``(6) 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.''.
    (b) Conforming Amendment.--Section 104(c) of the Foreign Assistance 
Act of 1961 (22 U.S.C. 2151b(c)) is amended by striking paragraph (7).
    (c) Effective Date.--The amendments made by this section shall take 
effect on October 1, 2003, or the date of the enactment of this Act, 
whichever occurs later.

SEC. 4. AUTHORIZATION OF APPROPRIATIONS FOR GLOBAL TUBERCULOSIS 
              ACTIVITIES OF THE CENTERS FOR DISEASE CONTROL AND 
              PREVENTION.

    For the purpose of carrying out global tuberculosis activities 
through the Centers for Disease Control and Prevention, there are 
authorized to be appropriated $30,000,000 for fiscal year 2004, and 
such sums as may be necessary for fiscal year 2005. Such authorization 
is in addition to other authorizations of appropriations that are 
available for such purpose. Amounts appropriated under this section 
shall remain available until expended.
                                 <all>