Whereas tuberculosis (hereafter in this preamble referred
to as TB
) is the second leading global infectious disease killer
behind HIV/AIDS, claiming 1,800,000 million lives each year;
Whereas the global TB pandemic and the spread of drug
resistant TB present a persistent public health threat to the United
States;
Whereas according to 2009 data of the World Health
Organization, 5 percent of all new TB cases are drug resistant;
Whereas TB is the leading killer of people with
HIV/AIDS;
Whereas TB is the third leading killer of adult women, and
the stigma associated with TB disproportionately affects women, causing them to
delay seeking care and interfering with treatment adherence;
Whereas the Institute of Medicine (IOM) found that the
resurgence of TB between 1980 and 1992 was caused by cuts in TB control funding
and the spread of HIV/AIDS;
Whereas, although the numbers of TB cases in the United
States continue to decline, progress towards TB elimination has slowed, and it
is a disease that does not recognize borders;
Whereas New York City had to spend over $1,000,000,000 to
control a multi-drug resistant TB outbreak between 1989 and 1993;
Whereas an extensively drug resistant form of TB, known as
XDR–TB (hereafter referred to in this preamble as XDR–TB)
), is
very difficult and expensive to treat and has high and rapid fatality rates,
especially among HIV/AIDS patients;
Whereas the United States has had more than 83 cases of
XDR–TB over the last decade;
Whereas the Centers for Disease Control and Prevention
estimated in 2009 that it costs $483,000 to treat a single case of
XDR–TB;
Whereas African-Americans are 8 times more likely to have
TB than Caucasians, and significant disparities exist among other United States
minorities, including Native Americans, Asian-Americans, and Hispanic
Americans;
Whereas the United States public health system has the
expertise to eliminate TB, but many State TB programs have been left seriously
under-resourced due to budget cuts at a time when TB cases are growing more
complex to diagnose and treat;
Whereas, although drugs, diagnostics and vaccines for TB
exist, these technologies are antiquated and are increasingly inadequate for
controlling the global epidemic;
Whereas the most commonly used TB diagnostic in the world,
sputum microscopy, is more than 100 years old and lacks sensitivity to detect
TB in most HIV/AIDS patients and in children;
Whereas current tests to detect drug resistance take at
least 1 month to complete and faster drug susceptibility tests must be
developed to stop the spread of drug resistant TB;
Whereas the TB vaccine, BCG, provides some protection to
children, but has little or no efficacy in preventing pulmonary TB in
adults;
Whereas there is also a critical need for new TB drugs
that can safely be taken concurrently with antiretroviral therapy for
HIV;
Whereas the Global Health Initiative commits to reducing
TB prevalence by 50 percent through 2015;
Whereas enactment of the Lantos-Hyde Global Leadership
Against HIV/AIDS, TB and Malaria Act and the Comprehensive TB Elimination Act
provide an historic United States commitment to the global eradication of TB,
including to the successful treatment of 4,500,000 new TB patients and 90,000
new multi-drug resistant (MDR) TB cases by 2013, while providing additional
treatment through coordinated multilateral efforts;
Whereas the United States Agency for International
Development provides financial and technical assistance to nearly 40 highly
burdened TB countries and supports the development of new diagnostic and
treatment tools, and is authorized to support research to develop new vaccines
to combat TB;
Whereas the Centers for Disease Control and Prevention,
working in partnership with States and territories of the United States,
directs the national TB elimination program and essential national TB
surveillance, technical assistance, prevention activities and supports 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 into the identification, treatment and prevention of TB; and
Whereas the Global Fund to Fight AIDS, Tuberculosis and
Malaria provides 63 percent of all international financing for TB programs
worldwide and finances proposals worth $3,200,000,000 in 112 countries, and TB
treatment for 6,000,000 and HIV/TB services for 1,800,000, and in many
countries in which the Global Fund supports programs, TB prevalence is
declining, as are TB mortality rates: Now, therefore, be it
That the House of Representatives—
(1)commends the
progress made by anti-tuberculosis programs, including the U.S. Agency for
International Development, the Centers for Disease Control and Prevention and
the Global Fund to Fight AIDS, Tuberculosis and Malaria; and
(2)reaffirms its
commitment to global tuberculosis control made through the Lantos-Hyde U.S.
Leadership Against HIV/AIDS, Tuberculosis and Malaria Act of 2008.