[Congressional Bills 117th Congress]
[From the U.S. Government Publishing Office]
[S. Res. 137 Introduced in Senate (IS)]

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117th CONGRESS
  1st Session
S. RES. 137

Supporting the goals of World Tuberculosis Day to raise awareness about 
                             tuberculosis.


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

                             March 25, 2021

   Mr. Brown (for himself and Mr. Sullivan) submitted the following 
  resolution; which was referred to the Committee on Foreign Relations

_______________________________________________________________________

                               RESOLUTION


 
Supporting the goals of World Tuberculosis Day to raise awareness about 
                             tuberculosis.

Whereas, in 2019, nearly \1/4\ of the global population was infected with the 
        tuberculosis bacterium (referred to in this preamble as ``TB'');
Whereas the World Health Organization (referred to in this preamble as the 
        ``WHO'') estimates that 10,000,000 people developed TB in 2019, 8.2 
        percent of whom were also infected with the human immunodeficiency virus 
        (referred to in this preamble as ``HIV'');
Whereas, in 2019, TB killed an estimated 1,408,000 people, causing more deaths 
        worldwide than any other single infectious agent;
Whereas, globally in 2019, an estimated 1,200,000 children developed TB, and in 
        2017, 230,000 children died of TB;
Whereas \2/3\ of new TB infections in 2019 occurred in 8 countries: India, 
        Indonesia, China, the Philippines, Pakistan, Nigeria, Bangladesh, and 
        South Africa;
Whereas TB is a leading killer of people infected with HIV, and 208,000 people 
        with HIV died of TB in 2019;
Whereas vulnerable populations also at high risk for developing TB include 
        individuals who are pregnant and newborns;
Whereas, in 2018, TB was one of the 6 leading causes of death among adult women 
        between the ages of 15 and 49 in low-income countries;
Whereas, in some settings, women with TB can face stigma, discrimination, and 
        ostracization by their families and communities;
Whereas the global TB epidemic and the spread of drug-resistant TB present a 
        persistent public health threat to the United States because the disease 
        does not recognize borders;
Whereas antibiotic-resistant pathogens are a growing problem worldwide, and 
        drug-resistant TB can occur when the drugs used to treat TB are 
        mismanaged or not made consistently accessible;
Whereas studies have demonstrated direct person-to-person transmission of drug-
        resistant TB;
Whereas multi-drug resistant TB (referred to in this preamble as ``MDR-TB'') is 
        caused by bacteria with resistance to rifampin and isoniazid, the 2 most 
        potent treatments for TB infection;
Whereas, in 2019, according to the 2020 WHO Global Tuberculosis Report, an 
        estimated 3.3 percent of all new TB cases and 18 percent of previously 
        treated cases were MDR-TB or rifampin-resistant TB;
Whereas, in 2019, an estimated 465,000 people around the world developed MDR-TB 
        or rifampin-resistant TB, yet only approximately 38 percent of those 
        individuals were identified and treated;
Whereas extensively drug-resistant TB (referred to in this preamble as ``XDR-
        TB'') is a rare type of TB that is resistant to nearly all medicines, 
        and therefore can be very difficult and expensive to treat, especially 
        among patients with HIV;
Whereas, in 2019, every WHO region reported XDR-TB cases;
Whereas, in 2019, the Centers for Disease Control and Prevention (referred to in 
        this preamble as ``CDC'') estimated that the average cost of treating a 
        single patient with MDR-TB in the United States was $178,000, and the 
        average cost of treating a patient with XDR-TB was even higher at 
        $553,000, compared with $20,000 to treat a patient with drug-susceptible 
        TB;
Whereas, between 2005 and 2007, according to an analysis by CDC, MDR-TB and XDR-
        TB cases in the United States collectively cost the health care system 
        an estimated $53,000,000;
Whereas CDC estimates that costs resulting from all forms of TB in the United 
        States totaled more than $608,000,000 in 2019;
Whereas, in a 2000 report, the Institute of Medicine found that a decrease in TB 
        control funding and the spread of HIV and acquired immune deficiency 
        syndrome (commonly referred to as ``AIDS'') caused a resurgence of TB in 
        the late 1980s and early 1990s;
Whereas a total of 8,916 TB cases were reported in the United States in 2019, 
        representing all 50 States and the District of Columbia, and up to 
        13,000,000 people in the United States are estimated to be living with 
        latent TB infection;
Whereas 75 percent of States have reported an increase in the proportion of 
        complex cases of TB in recent years due to factors such as homelessness, 
        HIV infection, drug resistance, substance abuse, refugee status, and 
        other factors;
Whereas the rate of TB disease in African Americans is 8 times higher than the 
        rate of disease in White, non-Hispanic Americans, and significant 
        disparities exist among other minorities in the United States, including 
        Asian Americans, Hispanic Americans, and Native Americans and Alaska 
        Natives, with approximately 88 percent of all reported TB cases in the 
        United States in 2019 occurring in racial or ethnic minorities;
Whereas smoking--

    (1) greatly increases the risks of contracting TB and infection 
recurrence; and

    (2) impairs therapeutic efficacy;

Whereas diabetes is a major risk factor for TB, and people with diabetes are 
        more likely to develop and succumb to TB;
Whereas bedaquiline is an antibiotic that boosts an MDR-TB patient's chance of 
        survival from approximately 50 percent to as much as 80 percent, and 
        through a public-private partnership, the United States Agency for 
        International Development (referred to in this preamble as ``USAID'') 
        provided approximately 105,000 treatments in 110 eligible countries from 
        2015 through 2019;
Whereas Bacillus Calmette-Guerin, a TB vaccine that is known as ``BCG'', 
        provides some protection to infants and young children against serious 
        forms of childhood TB but has had little epidemiologic impact on 
        controlling TB worldwide;
Whereas there is a critical need for new drugs, diagnostics, and vaccines for 
        controlling the global TB epidemic;
Whereas, in September 2018, the United Nations held the first high-level meeting 
        on TB in which 120 countries, including the United States, signed a 
        political declaration committing to accelerating the TB response, 
        including by increasing funding for TB control programs and research and 
        development efforts, with the goal of reaching all affected people with 
        TB prevention and care;
Whereas the enactment of the Tom Lantos and Henry J. Hyde United States Global 
        Leadership Against HIV/AIDS, Tuberculosis, and Malaria Reauthorization 
        Act of 2008 (Public Law 110-293; 122 Stat. 2918), and the Comprehensive 
        Tuberculosis Elimination Act of 2008 (Public Law 110-392; 122 Stat. 
        4195) led to a historic United States commitment to support the global 
        eradication of TB, including a commitment to treat 4,500,000 TB patients 
        and 90,000 MDR-TB patients between 2009 and 2013 and to provide 
        additional treatment through coordinated multilateral efforts;
Whereas USAID--

    (1) provides technical assistance to 55 countries and implements 
bilateral programs in 23 high-burden TB countries that--

    G    (A) build capacity; and

    G    (B) support the adoption of state-of-the-art TB-related 
technologies;

    (2) supports the development of new diagnostic and treatment tools; and

    (3) supports research to develop new vaccines and other new methods to 
combat TB;

Whereas, in 2018, USAID launched--

    (1) a new business model entitled ``Global Accelerator to End 
Tuberculosis'' to accelerate progress and build capacity with respect to TB 
prevention and treatment; and

    (2) a new mechanism to directly support local organizations in priority 
countries;

Whereas TB incidence in the countries that receive bilateral TB funding from the 
        United States through USAID has decreased by more than 29 percent since 
        2000;
Whereas, according to the Copenhagen Consensus Center, TB prevention programs 
        return $56 for each dollar invested, which is one of the highest returns 
        on investment of any health intervention;
Whereas CDC, in partnership with other entities of the United States and 
        individual States and territories--

    (1) directs the national TB elimination program;

    (2) coordinates TB surveillance, technical assistance, and prevention 
activities; and

    (3) helps to support 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 on the 
        identification, treatment, and prevention of TB;
Whereas the Global Fund to Fight AIDS, Tuberculosis and Malaria (referred to in 
        this preamble as the ``Global Fund''), to which the United States is a 
        top financial donor, provides more than 73 percent of all international 
        financing for TB programs;
Whereas, in 2019, Global Fund-supported programs detected and treated more than 
        5,700,000 cases of TB;
Whereas the coronavirus disease 2019 (COVID-19) pandemic and mitigation efforts 
        put in place as a result of the pandemic have taken a devastating toll 
        on countries with the highest burden of TB disease and on the global TB 
        response, threatening to reverse up to 8 years of progress fighting the 
        disease;
Whereas, in 2020, in the 23 high-burden TB countries in which USAID implements 
        bilateral programs, 1,000,000 fewer people with TB had access to 
        diagnosis and treatment, a 23 percent decline from 2019;
Whereas, between 2020 and 2025, global projections estimate that the impact of 
        the COVID-19 pandemic will lead to an additional 6,300,000 cases of TB 
        and an additional 1,400,000 TB deaths; and
Whereas March 24, 2021, is World Tuberculosis Day, a day that commemorates the 
        date in 1882 on which Dr. Robert Koch announced his discovery of 
        Mycobacterium tuberculosis, the bacterium that causes TB: Now, 
        therefore, be it
    Resolved, That the Senate--
            (1) supports the goals of World Tuberculosis Day to raise 
        awareness about tuberculosis;
            (2) commends the progress of tuberculosis elimination 
        efforts by entities that include the United States Agency for 
        International Development, the Centers for Disease Control and 
        Prevention, the National Institutes of Health, the World Health 
        Organization, and the Global Fund to Fight AIDS, Tuberculosis 
        and Malaria; and
            (3) reaffirms the commitment to strengthen the leadership 
        role of the United States in, and the effectiveness of the 
        global response to, the fight to end the tuberculosis epidemic.
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