[Congressional Record Volume 146, Number 28 (Tuesday, March 14, 2000)]
[House]
[Page H937]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                   TUBERCULOSIS, A WORLDWIDE EPIDEMIC

  The SPEAKER pro tempore. Under the Speaker's announced policy of 
January 19, 1999, the gentleman from Ohio (Mr. Brown) is recognized 
during morning hour debates for 5 minutes.
  Mr. BROWN of Ohio. Madam Speaker, remember when we were children, in 
some cases 30, 40, 50 years ago, tuberculosis clinics were closing in 
virtually every community in America. I remember growing up in 
Mansfield, Ohio, in the 1950s and 1960s; and I remember that 
tuberculosis clinic was closed there because Americans realized that 
tuberculosis was not really much of a problem in the United States of 
the 1960s or 1970s or 1980s.
  People are surprised in this country, Members of Congress are 
surprised, citizens are surprised, to learn that tuberculosis in 1999 
killed 2 million people around the world. It killed more people in 1999 
around the world than in any year in history. Tuberculosis is one of 
the greatest infectious disease killers of adults worldwide, killing 
someone every 15 seconds. It is the biggest killer of young women 
around the world. It is the biggest killer of people with HIV/AIDS. Of 
the deaths from AIDS in Africa, literally one-third of those deaths 
actually are from tuberculosis.
  The World Health Organization estimates that one-third of the world's 
population of the 6 billion people in the world, some 2 billion are 
infected with the bacteria that causes tuberculosis, including an 
estimated 10 to 15 million people in the United States.
  In India, 1,300 people a day in India, 1,300 people a day die from 
tuberculosis. An estimated 8 million people around the world develop 
active TB each year. It is spreading as a result of inadequate 
treatment, and it is a disease that knows no national borders; and it 
is becoming more and more of a problem in the United States. The threat 
that TB poses for Americans derives, one, from the global spread of 
tuberculosis and, second, from the emergence and spread of strains of 
tuberculosis that are multidrug resistant.
  In the U.S., TB treatment is normally only about $2,000 per patient 
in the United States and in developing countries as little as $15 or 
$20 or no more than $100 per patient, regular, sort of standard 
tuberculosis. The costs can go up to as much as $250,000 a patient to 
treat multidrug resistant tuberculosis, and the treatment is much less 
likely to be successful.
  Multidrug-resistant TB kills more than half those infected even in 
the United States and other industrialized nations.
  Madam Speaker, the gentlewoman from Maryland (Mrs. Morella), 
Republican from Maryland, and I are bipartisanly sponsoring legislation 
which will authorize an appropriation of $100 million to U.S. Agency 
for International Development, USAID, for the purpose of diagnosing and 
treating TB in high-incidents countries. The director general of the 
World Health Organization, Secretary General Gro Brundtland, said that 
tuberculosis is not a medical problem, it is a political problem. We 
know how to take care of people with tuberculosis. We know how to treat 
tuberculosis. The question is the political will to do it, the 
resources available to do it.
  Tuberculosis experts estimate that it will cost an additional $1 
billion each year worldwide to control this disease.

                              {time}  1300

  The great majority of funds are used for the direct implementation of 
DOTS Tuberculosis Control Program, DOTS stands for directly observed 
treatment, where a person infected with TB must take medication every 
day for up to 6 months, and, if they stop taking it, then even when 
they stop coughing up blood or stop showing symptoms of TB, their 
multi-drug-resistant TB can come back. That is why it is simple to 
treat, but difficult to make sure that people take their medicine every 
day.
  The medicine is there. The will needs to be there, the outreach 
workers need to be available, whether it is in the United States or 
India or Nigeria or wherever across the world.
  Resources under our legislation will be used primarily in those 
countries having the highest incidence of tuberculosis. It is a problem 
worldwide that we as a wealthy country have a moral obligation to deal 
with. It is a problem worldwide that we have a practical reason to deal 
with, because tuberculosis, with more tourism, travel, with more 
business development, with more trade, with more airplanes, 
tuberculosis has come into our country in greater and greater 
incidence, unless we in fact try to deal with tuberculosis 
internationally.
  That is why we already have bipartisan support for the legislation 
that the gentlewoman from Maryland (Mrs. Morella) and I are working on. 
That is why I ask other Members to join us in cosponsoring this 
legislation which I will be introducing next week. March 24 is 
International Tuberculosis Day. We will be introducing the bill next 
week, the week of March 24, and ask other Members to cosponsor it.

                          ____________________