[Congressional Bills 116th Congress]
[From the U.S. Government Publishing Office]
[H.R. 3460 Introduced in House (IH)]
<DOC>
116th CONGRESS
1st Session
H. R. 3460
To facilitate effective research on and treatment of neglected tropical
diseases through coordinated international efforts.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
June 25, 2019
Mr. Smith of New Jersey (for himself, Mr. McCaul, Ms. Bass, Mr.
Sherman, Mr. Meeks, and Mr. Cicilline) introduced the following bill;
which was referred to the Committee on Foreign Affairs
_______________________________________________________________________
A BILL
To facilitate effective research on and treatment of neglected tropical
diseases through coordinated international efforts.
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 ``End Neglected Tropical Diseases
Act''.
SEC. 2. TABLE OF CONTENTS.
Sec. 1. Short title.
Sec. 2. Table of contents.
Sec. 3. Statement of policy.
Sec. 4. Findings.
Sec. 5. Definition.
Sec. 6. Rule of construction.
Sec. 7. Expansion of United States Agency for International Development
Neglected Tropical Diseases Program.
Sec. 8. Actions by Department of State.
Sec. 9. Multilateral development and health institutions.
SEC. 3. STATEMENT OF POLICY.
It is the policy of the United States to support a broad range of
implementation and research and development activities that work toward
the achievement of cost-effective and sustainable treatment, control,
and, where possible, elimination of neglected tropical diseases for the
economic and social well-being of all people.
SEC. 4. FINDINGS.
Congress finds the following:
(1) The World Health Organization (WHO) has identified 17
neglected tropical diseases (NTDs). Approximately 2 billion
people, almost one-third of the world's population, are at risk
of contracting an NTD, and more than 1.4 billion people are
currently afflicted with 1 or more NTDs.
(2) In 2013, WHO adopted a comprehensive resolution on NTDs
recognizing that increased national and international
investments in prevention and control of neglected tropical
diseases have succeeded in improving health and social well-
being in many countries.
(3) NTDs have an enormous impact in terms of disease burden
and quality of life. NTDs cause the loss of up to 534,000 lives
and 57 million disability-adjusted life-years each year. NTDs
surpass both malaria and tuberculosis in causing greater loss
of life-years to disability and premature death. Many NTDs
cause disfigurement and disability, leading to stigma, social
discrimination, and societal marginalization.
(4) NTDs create an economic burden of billions of dollars
through the loss of productivity and high costs of health care
required for treatment. People afflicted by NTDs are less
productive than their healthy counterparts. NTDs jeopardize the
ability of people to attend work and school, or to produce at
full capacity. For example, controlling one NTD, hookworm, in
children can result in a 43-percent increase in future wage
earnings.
(5) The social, economic, and health burden of NTDs falls
primarily on low- and middle-income countries, where access to
safe water, sanitation, and health care is limited. At least
100 countries face 2 endemic NTD burdens, and 30 countries
carry 6 or more endemic NTDs.
(6) NTDs are not confined to the developing world, however.
Several NTD outbreaks have been reported in the United States
and other developed countries, especially among the poor. In
the United States, NTDs disproportionately affect people living
in poverty, and especially minorities, including up to 2.8
million African Americans with toxocariasis and 300,000 or more
people, mostly Hispanic Americans, with Chagas disease.
(7) Many NTDs can be controlled, prevented, and even
eliminated using low-cost, effective, and feasible solutions.
Understanding the economic burden of NTDs on productivity and
health care costs can help to assure governments and donors
that the resources directed toward NTDs represent a good
investment.
(8) Research and development efforts are immediately needed
for all NTDs, especially those for which limited or no
treatment currently exists.
(9) Critical to developing robust NTD control strategies
are epidemiological data that identify at-risk populations,
ensure appropriate treatment frequency, and inform decisions
about when treatment can be reduced or stopped.
(10) Of the 14 most common NTDs, roughly 80 percent of
infections are caused by soil-transmitted helminths (STH) and
schistosomiasis. STH are a group of 3 parasitic worms
(roundworms, whipworms, and hookworms) that afflict more than 1
billion people worldwide, including 600 million school-age
children, of whom more than 300 million suffer from severe
morbidity. Schistosomiasis is another helminth infection
affecting at least 200 million people in developing countries,
but some estimates indicate that the true number of people
affected may be double or even triple that number.
(11) The benefits of deworming are immediate and enduring.
A rigorous randomized controlled trial has shown school-based
deworming treatment to reduce school absenteeism by 25 percent.
School-based deworming also benefits young siblings and other
children who live nearby but are too young to be treated,
leading to large cognitive improvements equivalent to half a
year of schooling.
SEC. 5. DEFINITION.
In this Act, the term ``neglected tropical diseases'' or ``NTDs''--
(1) means infections caused by pathogens, including
viruses, bacteria, protozoa, and helminths that
disproportionately impact individuals living in extreme
poverty, especially in developing countries; and
(2) includes--
(A) Buruli ulcer (Mycobacterium Ulcerans
infection);
(B) Chagas disease;
(C) dengue or severe dengue fever;
(D) dracunculiasis (Guinea worm disease);
(E) echinococcosis;
(F) foodborne trematodiases;
(G) human African trypanosomiasis (sleeping
sickness);
(H) leishmaniasis;
(I) leprosy;
(J) lymphatic filariasis (elephantiasis);
(K) onchocerciasis (river blindness);
(L) scabies;
(M) schistosomiasis;
(N) soil-transmitted helminthiases (STH)
(roundworm, whipworm, and hookworm);
(O) taeniasis/cysticercosis;
(P) trachoma; and
(Q) yaws (endemic treponematoses).
SEC. 6. RULE OF CONSTRUCTION.
Nothing in this Act shall be construed to increase authorizations
of appropriations for the United States Agency for International
Development.
SEC. 7. EXPANSION OF UNITED STATES AGENCY FOR INTERNATIONAL DEVELOPMENT
NEGLECTED TROPICAL DISEASES PROGRAM.
(a) Findings.--Congress finds the following:
(1) Since fiscal year 2006, the United States Government
has been an essential leader in global efforts to control seven
targeted neglected tropical diseases: lymphatic filariasis
(elephantiasis), onchocerciasis (river blindness),
schistosomiasis, soil-transmitted helminthiases (roundworm,
whipworm, and hookworm), and trachoma. Additional information
suggests that such efforts could also produce collateral
benefits for at least three other neglected tropical diseases:
foodborne trematodiases, scabies, and yaws (endemic
treponematoses).
(2) The United States Government is a partner in the London
Declaration on Neglected Tropical Diseases (2012), which
represents a new, coordinated international push to accelerate
progress toward eliminating or controlling 10 NTDs by 2020.
(3) While many of the most common NTDs have safe, easy to
use, and effective treatments, treatment options for the NTDs
with the highest death rates, including human African
trypanosomiasis (sleeping sickness), visceral leishmaniasis,
and Chagas disease, are extremely limited.
(4) The United States Agency for International Development
(USAID) Neglected Tropical Diseases Program has made important
and substantial contributions to the global fight to control
and eliminate 5 of the most common NTDs. Leveraging more than
$15,700,000,000 in donated medicines, USAID has supported the
distribution of more than 1 billion treatments in 31 countries
across Africa, Asia, and Latin America and the Caribbean.
(5) Since 2014, the USAID Neglected Tropical Diseases
Program has been investing in research and development for the
treatment of certain NTDs to ensure that promising new
breakthrough medicines can be rapidly evaluated, registered,
and made available to patients.
(6) The USAID Neglected Tropical Diseases Program is a
clear example of a successful public-private partnership
between the Government and the private sector and should be
judiciously expanded, as practicable and appropriate.
(b) Sense of Congress.--It is the sense of Congress that the USAID
Neglected Tropical Diseases Program, as in effect on the date of the
enactment of this Act, should--
(1) provide integrated drug treatment packages to as many
individuals suffering from NTDs or at risk of acquiring NTDs,
including individuals displaced by manmade and natural
disasters, as logistically feasible;
(2) better integrate NTD control and treatment tools and
approaches into complementary development and global health
programs by coordinating, to the extent practicable and
appropriate, across multiple sectors, including those relating
to HIV/AIDS, malaria, tuberculosis, education, nutrition, other
infectious diseases, maternal and child health, and water,
sanitation, and hygiene;
(3) establish low-cost, high-impact community- and school-
based NTD programs to reach large at-risk populations,
including school-age children, with integrated drug treatment
packages, as feasible;
(4) as opportunities emerge and resources allow, engage in
research and development of new tools and approaches to reach
the goals relating to the elimination of NTDs as set forth by
the 2012 World Health Organization publication ``Accelerating
Work to Overcome the Global Impact of Neglected Tropical
Diseases: A Roadmap for Implementation'', including for Chagas
disease, Guinea worm, human African trypanosomiasis (sleeping
sickness), leprosy, and visceral leishmaniasis; and
(5) monitor research on and developments in the prevention
and treatment of other NTDs so breakthroughs can be
incorporated into the USAID Neglected Tropical Diseases
Program, as practicable and appropriate.
(c) Program Priorities.--The Administrator of USAID should
incorporate the following priorities into the USAID Neglected Tropical
Diseases Program (as in effect on the date of the enactment of this
Act):
(1) Planning for and conducting robust monitoring and
evaluation of program investments in order to accurately
measure impact, identify and share lessons learned, and inform
future NTD control and elimination strategies.
(2) Coordinating program activities with complementary
USAID development and global health programs, including
programs relating to water, sanitation, and hygiene, food and
nutrition security, and education (both primary and secondary),
in order to advance the goals of the London Declaration on
Neglected Tropical Diseases (2012).
(3) Including morbidity management in treatment plans for
high-burden NTDs.
(4) Incorporating NTDs included in the Global Burden of
Disease Study 2010 into the program as opportunities emerge, to
the extent practicable and appropriate.
(5) Continuing investments in the research and development
of new tools and approaches that complement existing research
investments and ensure that new discoveries make it through the
pipeline and become available to individuals who need them
most.
SEC. 8. ACTIONS BY DEPARTMENT OF STATE.
(a) Office of the Global AIDS Coordinator.--It is the sense of
Congress that the Coordinator of United States Government Activities to
Combat HIV/AIDS Globally should fully consider evolving research on the
impact of NTDs on efforts to control HIV/AIDS when making future
programming decisions, as necessary and appropriate.
(b) Global Programming.--
(1) In general.--The Secretary of State should encourage
the Global Fund to take into consideration evolving research on
the impact of NTDs on efforts to control HIV/AIDS when making
programming decisions, particularly with regard to female
genital schistosomiasis, which studies suggest may be one of
the most significant cofactors in the AIDS epidemic in Africa,
as necessary and appropriate.
(2) Global fund.--In this subsection, the term ``Global
Fund'' means the public-private partnership known as the Global
Fund to Fight AIDS, Tuberculosis and Malaria established
pursuant to Article 80 of the Swiss Civil Code.
(c) G-20 Countries.--The Secretary of State, acting through the
Office of Global Health Diplomacy, should encourage G-20 countries to
significantly increase their role in the control and elimination of
NTDs.
SEC. 9. MULTILATERAL DEVELOPMENT AND HEALTH INSTITUTIONS.
(a) Congressional Finding.--Congress finds that the treatment of
NTDs, including community- and school-based deworming programs, can be
a highly cost-effective intervention, and schools can serve as an
effective delivery mechanism for reaching large numbers of children
with safe treatment for soil-transmitted helminthiases (roundworm,
whipworm, and hookworm) in particular.
(b) United Nations.--The President should direct the United States
permanent representative to the United Nations to use the voice, vote,
and influence of the United States to urge the World Health
Organization and the United Nations Development Programme to--
(1) ensure the dissemination of best practices and
programming on NTDs to governments and make data accessible to
practitioners in an open and timely fashion;
(2) highlight impacts of community- and school-based
deworming programs on children's health and education,
emphasizing the cost-effectiveness of such programs;
(3) encourage governments to implement deworming campaigns
at the national level;
(4) consider the designation of a portion of grant funds of
the institutions to deworming initiatives and cross-sectoral
collaboration with water, sanitation, and hygiene efforts and
nutrition or education programming, as practicable and
appropriate;
(5) encourage accurate monitoring and evaluation of NTD
programs, including deworming programs; and
(6) engage governments in cross-border initiatives for the
treatment, control, prevention, and elimination of NTDs, and
assist in developing transnational agreements, when and where
necessary.
<all>