[Congressional Record Volume 146, Number 116 (Tuesday, September 26, 2000)]
[House]
[Page H8064]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




           THREAT OF TUBERCULOSIS SPREADING RAPIDLY WORLDWIDE

  The SPEAKER pro tempore (Mr. Ballenger). 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. Mr. Speaker, the threat of tuberculosis is 
spreading rapidly throughout the developing world. TB is the greatest 
infectious killer of adults worldwide, and it is the biggest killer of 
young women. More people died from tuberculosis last year around the 
world than any year in history. It kills 2 million people per year, one 
person every 15 seconds.
  Not surprisingly, the statistics on access to TB treatment worldwide 
are pretty grim. Fewer than one in five of those with tuberculosis are 
receiving appropriate treatment, something called Directly Observed 
Treatment, Short Course. Based on World Bank estimates, DOTS treatment 
is one of the most cost-effective health interventions available, 
costing as little as $20 in developing countries to save a life and 
producing cure rates of up to 90 to 95 percent, even in the poorest 
countries.
  We have a very small window of opportunity during which stopping TB 
would be very cost effective. If we wait, if we go too slowly, more 
strains of multidrug-resistant tuberculosis, so-called MDR-TB, will 
emerge. It will cost billions to control with no guarantee of success. 
Multidrug-resistant TB has been identified on every continent. 
According to the World Health Organization, MDR-TB ultimately threatens 
to return TB control to the pre-antibiotic era, which older people in 
this country are familiar with, where no cure for TB was available. In 
the U.S., TB treatment, normally about $2,000 per patient, skyrockets 
to $200,000 to $250,000 per patient when that patient is infected with 
MDR-TB, and treatment then may not even be successful.
  The Prime Minister of India visited the United States recently and 
spoke in this Chamber. During his trip, he and I discussed the growing 
threat of tuberculosis and other infectious diseases in South Asia. 
India has more TB cases than anywhere else in the world. Each day, 
1,200 Indians die of tuberculosis. The disease has become a very major 
barrier to social and economic development, costing the Indian economy 
an estimated $2 billion a year. Mr. Speaker, 300,000 children are 
forced to leave school each year because their parents have 
tuberculosis. More than 100,000 women with TB are rejected by their 
families, due to the social stigma attached to it.
  A recent World Health Organization study in India found that in areas 
where effective tuberculosis treatment was implemented, the TB death 
rate fell 85 percent. India has undertaken an aggressive campaign to 
control tuberculosis, and they need the world's help. TB experts 
estimate it will cost an additional $1 billion each year worldwide to 
control this disease. In the Foreign Operations appropriations bill, 
international tuberculosis control efforts have been allocated 
bipartisanly, $60 million towards that $1 billion world effort. This is 
a significant improvement from last year where TB control received $35 
million, and 3 years ago, when there was no money provided to TB at 
all.
  Gro Bruntland, the general director of the World Health Organization, 
said tuberculosis is not a medical issue, it is a political issue. 
Getting Americans engaged in an international medical issue like 
tuberculosis, even when addressing that issue serves our international 
humanitarian interests and our domestic practical interests, is an 
uphill battle. We have an opportunity in this country and in this 
Chamber to save millions of lives now and prevent millions of needless 
deaths in the future.

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