[Congressional Record Volume 147, Number 37 (Tuesday, March 20, 2001)]
[House]
[Pages H964-H969]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




         RECOGNIZING THE IMPORTANCE OF COMBATTING TUBERCULOSIS

  Mr. BALLENGER. Madam Speaker, I move to suspend the rules and agree 
to the resolution (H. Res. 67) recognizing the importance of combatting 
tuberculosis on a worldwide basis, and acknowledging the severe impact 
that TB has on minority populations in the United States, as amended.
  The Clerk read as follows:

                               H. Res. 67

       Whereas tuberculosis is a horrible disease that is 
     preventable and treatable;
       Whereas one third of the world's population is infected 
     with the TB bacteria, including between 10 and 15 million 
     people in the United States;
       Whereas someone in the world dies of TB every 15 seconds;
       Whereas TB will kill more people this year than any other 
     year in history;
       Whereas TB rates are substantially higher for minorities in 
     the United States;
       Whereas African Americans suffer from TB at a rate that is 
     eight times greater than that of Caucasians, Latinos at six 
     times greater, Native Americans at five times greater and 
     Asians at a rate of nearly fifteen times greater;
       Whereas a substantial number of States have TB rates above 
     the national average, the highest rates being found in Texas, 
     Hawaii, California, Alaska, Florida, Georgia, and New York;
       Whereas the increased threat of TB emerging in the United 
     States is an unavoidable byproduct of increased international 
     travel, commerce, and migration;
       Whereas leading TB experts agree that in order to control 
     TB in the United States, it is necessary to control TB in the 
     developing countries that contribute the vast majority of the 
     global TB burden and are the destination of tens of thousands 
     of American visitors each year; and
       Whereas it is possible to control tuberculosis worldwide, 
     as the global community eradicated smallpox and may soon 
     eradicate polio, if the worldwide political will to do so is 
     found: Now, therefore, be it
       Resolved, That the House of Representatives--
       (1) recognizes the importance of increasing United States 
     investment in international tuberculosis control within the 
     foreign aid budget for fiscal year 2002;
       (2) recognizes the importance of supporting and expanding 
     domestic efforts to eliminate TB in the United States; and
       (3) calls upon local, national and global leaders, 
     including the President of the United States, to commit to 
     putting an end to the worldwide TB epidemic.

  The SPEAKER pro tempore. Pursuant to the rule, the gentleman from 
North Carolina (Mr. Ballenger) and the gentleman from California (Mr. 
Lantos) each will control 20 minutes.
  The Chair recognizes the gentleman from North Carolina (Mr. 
Ballenger).


                             General Leave

  Mr. BALLENGER. Mr. Speaker, I ask unanimous consent that all Members 
may have 5 legislative days within which to revise and extend their 
remarks and include extraneous material on the resolution presently 
being considered.
  The SPEAKER pro tempore. Is there objection to the request of the 
gentleman from North Carolina?
  There was no objection.
  Mr. BALLENGER. Madam Speaker, I yield myself such time as I may 
consume.
  Madam Speaker, H.R. 67, introduced by our colleagues, the gentleman 
from Texas (Mr. Reyes) and the gentleman from Texas (Mr. Rodriguez), 
seeks to draw more attention at home and abroad to the growing threat 
posed by tuberculosis. This deadly disease not only poses a threat 
throughout the developing world, but also disproportionately afflicts 
minority and poor populations in the United States.

[[Page H965]]

  Tragically, Madam Speaker, one-third of the world's population is 
infected with tuberculosis, a treatable and curable disease. Yet 
millions die from the disease because its victims lack education and an 
awareness about its deadly consequences on them or the meager resources 
needed for treatment. More alarming is the fact that between 10 million 
and 15 million Americans are infected with tuberculosis in the United 
States and thousands die of that disease each year.
  Madam Speaker, every 15 seconds a person is infected with the deadly 
tuberculosis virus; and as a consequence, more people will die of the 
disease this year than in any other year in history. It is also 
important to underscore that infectious diseases know no borders and 
that as a result of travel and commerce, more and more Americans, 
especially the poor and minorities, will become infected and die from 
this preventable disease.
  The global community worked collectively to eradicate smallpox and is 
working to rid the world of the polio virus. We can do the same with 
regard to tuberculosis. It is also possible to save lives by providing 
the poor and minorities in our own country as well as overseas with 
inexpensive tuberculosis treatment. Madam Speaker, this is not only the 
right thing to do, it is the smart thing to do. By saving lives, we can 
increase the productivity and lessen the burden on our taxed health 
care systems, both in the United States and overseas.
  Therefore, Madam Speaker, it is important for the Congress to pass 
H.R. 67 in order to recognize the challenge posed by the tuberculosis 
epidemic and to redouble our efforts to combat and eradicate this 
terrible and deadly disease. This is another example of how America can 
act globally to serve its own interests at home.
  I commend my colleagues for drafting this timely and important 
resolution, and I urge them to vote for its adoption.
  Madam Speaker, I reserve the balance of my time.
  Mr. LANTOS. Madam Speaker, I rise in strong support of this 
resolution, and I yield myself such time as I might consume.
  Madam Speaker, H. Res. 67 expresses support for increased United 
States funding for international tuberculosis treatment and eradication 
efforts. I would first like to commend my friend and colleague, the 
gentleman from Texas (Mr. Reyes), for introducing this resolution.
  This resolution before us today calls for increasing U.S. investment 
substantially in international tuberculosis control within the Foreign 
Aid budget for fiscal year 2002. The Reyes resolution also recognizes 
the importance of supporting and expanding domestic efforts to 
eliminate TB and calls on international leaders to commit to putting an 
end to the worldwide TB epidemic.
  Madam Speaker, March 24 is World TB Day, the day dedicated to raising 
awareness of the terrible toll inflicted by tuberculosis and to 
increase support for fighting TB. It is, therefore, appropriate that we 
are taking up this resolution today, just a few days prior to World 
Tuberculosis Day.
  Madam Speaker, tuberculosis kills 2 million people every single year. 
That is one person every 15 seconds. Globally, tuberculosis is the 
leading cause of death of young women and the leading cause of death of 
people with HIV/AIDS. The World Health Organization, Madam Speaker, 
estimates that one-third of the world's population is infected with 
bacteria that cause tuberculosis, including an estimated 10 million to 
15 million people here in the United States. Tuberculosis is spreading 
as a result of inadequate treatment, and it is a disease that knows no 
national borders.
  In order to control TB in the United States in a more effective 
manner, it is critical that we ensure the effectiveness of TB-
controlled programs globally. There is a highly effective and 
inexpensive treatment for tuberculosis. It is recommended by the World 
Health Organization as the best method for treating TB. The strategy is 
known as Directly Observed Treatment Short Course, DOTS for short. It 
produces high cure rates, prevents the further spread of the infection, 
and prevents the development of strains of multi-drug resistant TB. Yet 
fewer than one in five of those ill with tuberculosis are receiving 
this treatment.
  Based on the estimates of the World Bank, Madam Speaker, this 
treatment is one of the most cost-effective health interventions 
available, costing less than $100 to save a life. It can produce cure 
rates of up to 95 percent, even in the poorest countries.
  Madam Speaker, I think the United States should commit more of our 
resources to support this treatment globally. It is the only way that 
we will be able to stop TB here in the United States and across the 
globe. I believe that passage of the Reyes resolution will signal that 
this House of Representatives strongly supports increased funding for 
the global battle against tuberculosis.
  I commend the gentleman from Texas (Mr. Reyes) for introducing this 
resolution, and I urge all of my colleagues to support H. Res. 67.
  Madam Speaker, I reserve the balance of my time.
  Mr. BALLENGER. Madam Speaker, I reserve the balance of my time.
  Mr. LANTOS. Madam Speaker, I am pleased to yield as much time as he 
may consume to the gentleman from Texas (Mr. Reyes), my friend and 
colleague, and the author of this most important resolution.
  Mr. REYES. Madam Speaker, I thank the gentleman from California (Mr. 
Lantos) for yielding me this time this afternoon.
  Madam Speaker, I rise today to encourage my colleagues to support a 
very important resolution. This resolution recognizes the importance of 
combatting tuberculosis commonly referred to as TB, on a worldwide 
basis and acknowledges the severe impact that TB has on minority 
populations in the United States.
  As I speak this afternoon, I want my colleagues to focus on these 
four statistics: someone in the world is infected with TB every second 
of every day; someone in the world dies of TB every 15 seconds; TB 
kills 2 million people every year; and TB rates are substantially 
higher for minorities in the United States.
  I introduced this resolution with the gentleman from Texas (Mr. 
Rodriguez), my friend and colleague, because the problem of 
tuberculosis, which many people think of as a disease of the past that 
has largely been eradicated, is again posing a serious threat to the 
health and security of our Nation. We must exert maximum effort to 
combat this disease on a global scale.
  Madam Speaker, tuberculosis is a horrible disease that is preventable 
and treatable; yet one-third of the world's population is infected with 
the TB bacteria, including between 10 million and 15 million people in 
the United States. Every second of every day, a person somewhere in the 
world is infected with TB. Every second of every day, additionally, 
someone in the world dies of TB. This treatable disease will kill more 
people this year than any other time in our history.
  Furthermore, TB rates are substantially higher for minorities in the 
United States, with African Americans suffering from this disease at a 
rate that is eight times greater than that of Caucasians; Latinos at a 
rate that is six times greater than Caucasians; Native Americans at a 
rate of five times greater; and Asians at a rate of nearly 15 times 
greater. Everything possible needs to be done to stop this disease in 
its tracks. I am greatly concerned with the TB infection rates along 
the U.S.-Mexico border as well. Texas and California have TB rates 
above the national average.
  Madam Speaker, TB is emerging in the United States as an unavoidable 
by-product of increased international travel, commerce, and migration. 
It is necessary to control TB in developing countries if we are going 
to control it here within our own borders in the United States. We need 
to eradicate TB just as we have eradicated smallpox.
  Madam Speaker, we need to substantially increase the investment in 
international tuberculosis control within the foreign aid budget for 
fiscal year 2002. We need to recognize the importance of supporting and 
expanding domestic efforts to eliminate TB in the United States, and we 
all need to work together to put an end to the worldwide TB epidemic.
  I ask my colleagues to support H. Res. 67. The World Health 
Organization has designated this coming Saturday

[[Page H966]]

 as World TB Day, and I cannot think of a more appropriate way to bring 
attention to this terrible disease this year than the passage of this 
resolution.
  Finally, I would like to thank the gentleman from California (Mr. 
Lantos), my good friend, and the gentleman from North Carolina (Mr. 
Ballenger), also my good friend, and their staffs for their work on the 
Committee on International Relations and for their help in managing 
this bill. I would also like to thank all of my colleagues who 
cosponsored this important legislation and who I am sure will keep up 
the fight to eradicate tuberculosis on a worldwide basis.
  Mr. LANTOS. Madam Speaker, I yield 5 minutes to the distinguished 
gentleman from Ohio (Mr. Brown).
  Mr. BROWN of Ohio. Madam Speaker, I thank the gentleman for yielding 
me this time.
  Tuberculosis is the greatest infectious killer of adults worldwide. 
Each year, 8 million people are diagnosed with tuberculosis and 2 
million die from it, one person every 15 seconds. In India alone, 1,100 
people die every day from tuberculosis. Not surprisingly, the 
statistics on access to TB treatment worldwide are pretty grim. Fewer 
than one in five of those with TB receive Directly Observed Treatment 
Short Course, or the so-called DOTS treatment.
  Based on World Bank estimates, DOTS treatment is one of the most 
cost-effective health interventions available, costing as little as 
$20, and no more than $100, in the developing world to save a life and 
producing cure rates of up to 95 percent, even in the poorest countries 
with the least developed health care infrastructure.

                              {time}  1430

  But we have a small window of opportunity during which stopping 
tuberculosis can be cost effective. The failure to effectively treat 
TB, which comes from incorrect or interrupted treatment and inadequate 
drug supplies, creates stronger strains that can become resistant to 
today's drugs.
  An epidemic of multi-drug resistant TB, so-called MDR-TB, multi-drug 
resistant TB, would cost billions to control, with no guarantee of 
success. MDR-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, the pre-1950s era, where no cure for 
TB was available.
  In the U.S., TB treatment, normally about $2,000 per patient, 
skyrockets to as much as a quarter million dollars per patient, what 
happened in New York City in the early 1990s, and an MDR-TB treatment 
may not even be successful.
  MDR-TB kills more than half of those infected in the United States 
and other industrialized nations. In the developing world, multi-drug 
resistant TB is an effective death sentence.
  As H. Res. 67 makes perfectly clear, more needs to be done.
  To control TB in the U.S. more effectively, it is necessary to ensure 
the effectiveness of TB control programs worldwide.
  It is not just the humanitarian and the right thing to do for us to 
work on TB in this country, it also makes a difference and work 
internationally on TB will make a difference in this country.
  This week I will be joined by the gentlewoman from Maryland (Mrs. 
Morella) and the gentleman from California (Mr. Waxman) in introducing 
two pieces of legislation responding to the global TB threat.
  Our global TB legislation calls for U.S. investment in international 
TB control of $200 million for next year, with a focus on expanding 
proven, low-cost TB treatment in countries with high levels of TB.
  Our domestic bill calls for an annual investment of $528 million in 
Atlanta's Centers for Disease Controls in their efforts to eliminate TB 
and $240 million in the National Institutes of Health TB research 
activities.
  The Director General of the World Health Organization, Gro Bruntland, 
said that TB is not a medical problem, it is a political problem. 
Getting Americans engaged in an international and a domestic issue like 
TB, even when addressing that issue serves our best interests, is an 
uphill battle. Still, it is one worth fighting.
  Madam Speaker, I thank the gentleman from California (Mr. Lantos) and 
the gentleman from Texas (Mr. Reyes) for their efforts on this issue. 
We have an opportunity to save millions of lives now and prevent 
millions of needless deaths in the future.
  Mr. BALLENGER. Madam Speaker, I submit the following exchange of 
letters for the RECORD between the gentleman from Illinois (Mr. Hyde) 
and the gentleman from Louisiana (Mr. Tauzin):
         House of Representatives, Committee on International 
           Relations,
                                   Washington, DC, March 19, 2001.
     Hon. W.J. ``Billy'' Tauzin,
     Chairman, Committee on Energy and Commerce,
     Rayburn House Office Building,
     Washington, DC.
       Dear Mr. Chairman: I have received your letter concerning 
     H. Res. 67, a resolution recognizing the importance of 
     combating tuberculosis on a worldwide basis. It is our 
     intention that the House consider this resolution on the 
     suspension calendar. The Committee on Energy and Commerce was 
     granted an additional referral on this resolution based on 
     its jurisdiction over public health issues.
       We recognize your jurisdiction, and appreciate your 
     willingness to waive your right to consider this resolution 
     without waiving your jurisdiction over the general subject 
     matter.
       As you have requested, I will include this exchange of 
     letters in the Congressional Record during consideration of 
     the resolution.
       I appreciate your assistance in getting this important 
     legislation to the floor.
           Sincerely,
                                                    Henry J. Hyde,
     Chairman.
                                  ____

                                         House of Representatives,


                             Committee on Energy and Commerce,

                                   Washington, DC, March 19, 2001.
     Hon. Henry J. Hyde,
     Chairman, Committee on International Relations,
     Rayburn House Office Building, Washington, DC.
       Dear Chairman Hyde: it is my understanding that the House 
     leadership has scheduled H. Res. 67, recognizing the 
     importance of combating tuberculosis, for floor action 
     tomorrow, March 20, 2001. As you know, the Committee on 
     Energy and Commerce was given a named additional referral on 
     this legislation.
       Because of the desire to bring this legislation before the 
     House in an expeditious manner, I will not exercise my 
     Committee's right to a referral. By agreeing to waive its 
     consideration of the bill, however, the Energy and Commerce 
     Committee does not waive its jurisdiction over H. Res. 67.
       I ask for your acknowledgment of the Energy and Commerce 
     Committee's jurisdiction over this legislation. I further 
     request that you include this letter as part of the Record 
     during consideration of the legislation on the House floor.
       Thank you for your attention to these matters.
           Sincerely,
                                            W.J. ``Billy'' Tauzin,
                                                         Chairman.

  Madam Speaker, I yield such time as she may consume to the 
gentlewoman from Maryland (Mrs. Morella).
  Mrs. MORELLA. Madam Speaker, I would like to, first of all, thank the 
gentleman from North Carolina (Mr. Ballenger), my colleague who was 
elected with me in the 10th Congress, for yielding the time.
  Madam Speaker, I rise in strong support of H. Res. 67, legislation 
which highlights the importance of combatting TB on a worldwide basis.
  I want to salute the gentleman from Texas (Mr. Reyes) and the 
gentleman from California (Mr. Lantos) for introducing this resolution.
  I also want to thank the gentleman from Ohio (Mr. Brown) for taking 
the lead with me in introducing legislation to increase the amount of 
money that we are expending as seed money to combat tuberculosis on a 
worldwide basis.
  My support is ongoing for programs which save, protect and enhance 
the lives of millions of people around the world, programs such as 
infectious disease control and tuberculosis control, in particular.
  International tuberculosis control has become an important issue to 
me over the past few years. Although it is not a widely known fact, TB 
is the biggest infectious killer of young women in the world. In fact, 
TB kills more women worldwide than all other causes of maternal 
mortality combined.
  Someone in the world is newly infected with TB every second, and 8 
million people become sick with the disease annually. TB accounts for 
more than 1 quarter of all preventable adult deaths in developing 
countries.
  Currently, an estimated one-third of the world's population, 
including 15 million people in the United States, are infected with the 
TB bacteria; and

[[Page H967]]

due to its infectious nature, TB cannot be stopped at national borders. 
It is impossible to control TB in the United States until we control it 
worldwide.
  Effective TB treatment is one of the most cost-effective, tangible 
interventions that can extend the life of HIV-infected persons, protect 
families from financial ruin and enable women and girls to enjoy a 
brighter future. Unfortunately, less than one in four of these infected 
with TB have access to proven treatment, a proven treatment called 
DOTs, despite the fact that it is extremely cost effective and produces 
cures of up to 90 percent.
  A full six-month course of drugs costs only $10 or $15, and this 
strategy has improved cure rates by up to 50 percent and has reduced 
drug resistance. However, I stress that only a quarter of the world's 
active TB patients now use DOTs. The World Health Organization, in 
collaboration with various governments, foundations and anti-TB groups, 
seeks to solve these problems by creating a global drug facility which 
will buy and supply good quality drugs to countries and nongovernmental 
organizations that agree to use them correctly.
  The United States must take a leadership role in supporting this 
initiative by substantially increasing spending programs to eliminate 
the spread of TB worldwide from $60 million to $200 million next year, 
with at least half of the money going to the drug facility.
  Until we control TB internationally, the minority sectors of our own 
society will continue to be severely impacted by this disease. Latinos 
suffer from TB at a rate that is six times that of Caucasians. Rates 
among African Americans are eight times higher, and Native Americans 
have an incidence five times greater. Moreover, TB affects Asians with 
an incidence nearly 15 times greater than Caucasians.
  Today, when people and diseases can reach any destination on the 
globe within 36 hours, TB anywhere is a threat everywhere. The longer 
we wait to address the TB epidemic, the more difficult and expensive it 
will be to eradicate the disease.
  H. Res. 67 summarizes exactly what we must do to achieve this end, 
and I urge the support of this body.
  Mr. LANTOS. Madam Speaker, I yield 3 minutes to the distinguished 
gentleman from Illinois (Mr. Davis), my good friend.
  Mr. DAVIS of Illinois. Madam Speaker, I rise today in support of H. 
Res. 67, which recognizes the importance of fighting tuberculosis 
worldwide and especially among minority populations in the United 
States. I commend the gentleman from Texas (Mr. Reyes), my good friend, 
for recognizing the increasing threat of tuberculosis worldwide and its 
reemergence in the United States.
  Decades ago in this country many Americans were forced into 
sanitariums as a way to control the spread of TB. Since then, there 
have been diagnostic and treatment advances that have led to a decline 
in the number of tuberculosis cases. In the United States between 1977 
and 1999, the cases of TB decreased by 42 percent. During this time, 
the cases of TB in Chicago also decreased by 57 percent.
  However, despite the decline of TB among the general population, a 
disturbing trend of TB remains prevalent among African Americans and 
other minority groups within the United States. The cases of TB between 
1995 and 1999 for African Americans in Chicago were more than four 
times higher as compared to nonHispanic whites.
  Although African Americans were recorded as less than 40 percent of 
Chicago's population, African Americans accounted for 62 percent of all 
recorded TB cases in Chicago. In 1999, Chicago was ranked the third 
highest in the Nation of TB cases, with 463 cases reported.
  The community of Chicago's Southside, where approximately 36 percent 
of the TB cases are reported, joined hands together with the help of 
the Metropolitan Chicago Tuberculosis Coalition and the American Lung 
Association of Metropolitan Chicago to develop priorities to move 
towards the decline in the number of TB cases. Education was listed as 
the first priority to help in reducing these cases; and I agree with 
the community leaders, health care professionals and individuals from 
organizations who are developing and implementing programs of education 
to educate citizens to become actively involved in fighting this 
dreaded disease.
  Again, Madam Speaker, I want to commend the gentleman from Texas (Mr. 
Reyes) and the gentleman from California (Mr. Lantos) and all of those 
who are calling for additional funding for tuberculosis both Nationwide 
and here at home.
  Mrs. CLAYTON. Madam Speaker, I am pleased to speak in support of H. 
Res. 67, recognizing the importance of combating tuberculosis on a 
worldwide basis, and acknowledge the severe impact that TB has on 
minority populations in the United States.


                              tb worldwide

  While TB is an ancient disease, it is also one of the world's 
deadliest. Every day, 20,000 people develop TB and 5,000 die from it. 
TB accounts for more than one quarter of all preventable adult deaths 
in developing countries.
  Each year, there are two million TB-related deaths worldwide and a 
disproportionate number of people who become sick with TB are the most 
vulnerable--women, the poor, the homeless, racial and ethnic minorities 
and people infected with HIV.
  TB is the leading killer of people who are HIV-infected, accounting 
for one third of AIDS deaths worldwide. People co-infected with HIV and 
TB are up to 800 times more likely to develop active TB during their 
lifetime than people without HIV infection.
  TB is the biggest killer of women, causing more deaths among women 
worldwide than all other causes of maternal mortality combined.


                        tb in the united states

  In the 1970s and '80s the United States let its guard down against 
TB. Many states and cities redirected TB prevention and control funds 
to other programs and TB came back with a vengeance. The trend toward 
elimination was reversed and the US experienced a resurgence of TB with 
a 20 percent increase in TB cases reported between 1985 and 1992. Many 
of these persons were suffering from difficult to treat drug-resistant 
TB.
  Today, 15 million people in our country are infected with the TB 
bacteria.
  TB rates are substantially higher for minorities in the United 
States.
  African-Americans suffer from TB at a rate that is eight times that 
of Caucasians.
  My state of North Carolina is just below the National average for TB 
cases. In 1999, North Carolina had a TB rate of 6.4 cases per 100,000 
persons. The goal on the Tuberculosis Control program in North Carolina 
is to reduce TB by the year of 2010 to under one case per one million 
persons, virtually eliminating TB in the state. This bill encourages 
leaders in my state, the nation, and world-wide to continue efforts to 
eliminate Tuberculosis.


                           what must be done

  The end of this week (March 24th) is World TB Day. This is the day we 
commemorate the discovery of the TB bacteria in 1882. Unfortunately, 
today we are further away from eliminating this killer than we were 
that day over 100 years ago.
  The global community has been complacent about this disease for too 
long. That is why I am pleased to support Mr. Reyes' Resolution 
commemorating this day and acknowledging the harsh toll that TB takes 
on minorities. In addition to acknowledging the continued impact of 
this disease, I also believe we here in the United States must greatly 
increase our investment in domestic and international TB control 
programs. Due to its infectious nature, the only way to control TB at 
home is to address it worldwide. We must invest in our future now, 
before it's too late--before the spread of drug-resistant TB becomes 
too difficult or too expensive to control at all.
  Ms. JACKSON-LEE of Texas. Madam Speaker, I rise in support of H. Res. 
67, Recognizing the Importance of Tuberculosis On A Worldwide Basis. 
This resolution marks a significant realization by the global public 
health community that we need to do more to stop this illness.
  One-third of the world's population, including between 10 million and 
15 million people in the United States, is infected with the 
tuberculosis (TB) bacteria, and rates of TB are substantially higher 
for minorities in the United States than for other Americans.
  This resolution recognizes the importance of ``substantially 
increasing United States investment in international tuberculosis 
control'' in the FY 2002 foreign aid budget. We can no longer delay in 
combating this illness with the priority it deserves. The resolution 
also recognizes the importance of supporting and expanding domestic 
efforts to eliminate tuberculosis (TB) in the United States and calls 
on local, national and world leaders, including the president, to 
``commit to putting an end to the worldwide TB epidemic.'' This is a 
global problem, which requires a rapid and effective response from all 
nations.
  The measure notes that the increased threat of TB emerging in the 
U.S. is an ``unavoidable byproduct of increased international travel, 
commerce, and migration,'' and that in order to control TB in the 
United States, it is necessary to control TB in developing countries.

[[Page H968]]

  Madam Speaker, TB is an avoidable problem, and, in many ways, is much 
easier to control than other epidemics. We are not doing enough, 
however, to keep TB from touching our children's lives. We must 
redouble our efforts as to stem the tide of the TB epidemic and 
disseminate the appropriate preventative measures to lessen the illness 
where possible.
  I urge my colleagues to support the resolution.
  Mr. BACA. Madam Speaker, I rise in support of H. Res. 67, recognizing 
the importance of tuberculosis funding.
  On March 24th, 1882, Dr. Robert Kotch discovered the bacteria that 
causes TB.
  More than a century later, TB is still a serious world threat. In 
fact, it kills more people today than it did a century ago.
  Somewhere in the world someone dies of TB every fifteen seconds.
  One third of the world's population is infected with the TB bacteria.
  This year alone, TB will take more than 2 million lives, including 
the lives of many minorities here in the United States. The illness is 
particularly affecting our African American population.
  This disease is a threat to all of us, including to my constituents 
in California, which has one of the highest rates of this illness in 
the country.
  Therefore, it is essential that we increase funding for TB control, 
and increase efforts to eliminate TB in the United States.
  We must call upon world leaders, including the President to commit to 
putting an end to this epidemic.
  Mr. GILMAN. Madam Speaker, I rise today in strong support of H. Res. 
67 and I commend my colleague, Mr. Reyes from Texas for bringing this 
important issue to our attention.
  Tuberculosis (TB) is a communicable disease caused by the bacteria 
tubercle bacillus and a related mycobacterium (Mycobacterium bovis). It 
is characterized by toxic or allergic symptoms that primarily affect 
the lungs. One third of the world's population is infected with the TB 
bacteria, including between 10 and 15 million people in the United 
States. A substantial number of states have TB rates above the national 
average. The highest rates are found in Texas, Hawaii, California, 
Alaska, Florida, Georgia, and my home state of New York. Additionally, 
TB rates are substantially higher among minorities in the United 
States. African Americans suffer from TB at a rate of eight times 
greater than Caucasians, Latinos at six times greater, Native Americans 
at five times greater and Asians at a rate of nearly fifteen times 
greater.
  Globally, 2 million people die from TB each year. It is estimated 
that between 2000 and 2020, nearly one billion people will be newly 
infected, 200 million people will get sick, and 35 million will die 
from TB--if control is not further strengthened. The global epidemic is 
growing and becoming more dangerous. The breakdown in health services, 
the spread of HIV/AIDS and the emergence of multidrug-resistant TB are 
contributing to the worsening impact of this disease. Leading TB 
experts agree that in order to control the disease in the United States 
it is necessary to control TB in the developing countries that 
contribute the majority of the global TB burden and are the destination 
of thousands of American visitors each year.
  H. Res. 67 recognizes the importance of substantially increasing the 
United States investment in international tuberculosis control within 
the foreign aid budget in fiscal year 2002 to help countries worldwide, 
recognizes the importance of supporting and expanding domestic efforts 
to eliminate tuberculosis in the United States and call upon local, 
national and global leaders to commit to putting an end to the 
worldwide tuberculosis epidemic. Accordingly, I urge my colleagues to 
support this measure and help limit the spread of this devastating 
disease.
  Mrs. CAPPS. Madam Speaker, I am pleased to speak in support of House 
Resolution 67, which recognizes the importance of combating 
tuberculosis on a worldwide basis and acknowledges the severe impact TB 
has had on minority populations in the United States.
  Leading experts on tuberculosis agree that in order to control this 
deadly disease in the United States, we need to control TB in the 
developing countries that make up the vast majority of the global TB 
burden. No one thinks this will be easy, but it is possible.
  The global community successfully eradicated smallpox and many soon 
get rid of polio. If the international community contributes the 
necessary resolve and resources, we can eradicate tuberculosis as well.
  In 1999, there were an estimated 8.4 million new cases of 
tuberculosis--up from 8 million in 1997. This increase was due in large 
part to a 20 percent increase in incidence in African countries with 
high HIV/AIDS rates. Most countries with rapidly growing HIV epidemics 
also have high TB rates. This is true for countries such as Brazil, 
Ethiopia, and Nigeria. This is typically because these countries lack 
the proper health care personnel, infrastructure, and funding. The link 
between HIV and TB rates means that we can expect several million 
additional new cases of TB as HIV continues to spread in high-
prevalence countries.
  TB is the leading cause of death from infection among young women 
worldwide. One third of the world's population is infected with the 
tuberculosis bacteria--including 10-15 million people in the United 
States--and every year between two to three million people die of this 
curable disease.
  On March 16, Archbishop Desmond Tutu officially launched World TB 
Day, and, on March 24, the international community will recognize World 
TB Day. The theme, ``DOTS (Directly Observed Treatment, Short-course)--
TB cure for all,'' call for equitable access to TB services for anyone 
with this disease. Access to treatment should be available to men and 
women, and rich and poor alike. It should also be available to 
vulnerable groups such as people with HIV or drug-resistant TB. The 
theme of a TB cure for all contributes to the fulfillment of everyone's 
right to the highest possible standard of health.
  TB rates tend to be significantly higher in the poor and 
disadvantaged worldwide, and TB rates are substantially higher for 
minorities in the United States. In fact, Asian Americans are fifteen 
times more likely to suffer from TB than Caucasians, African Americans 
are eight times more likely, Latinos are six times more likely, and 
Native Americans are five times more likely to suffer from this 
disease.
  I would like to take this opportunity to commend an organization in 
my district called Results. Results is a non-profit organization that 
seeks solutions to world hunger and poverty. Results is actively 
working to eradicate TB. I support this goal, and I want to make sure 
Congress provides the resources to assist in this effort.
  Madam Speaker, Congress has a duty to substantially increase the U.S. 
investment in international tuberculosis control, and to expand 
domestic efforts to eliminate TB in the United States. I am committed 
to making this happen, and I am pleased that this important resolution 
was brought to the House floor today.
  Ms. PELOSI. Madam Speaker, I rise today in strong support of H. Res. 
67 which recognizes the importance of combating tuberculosis worldwide 
and the severe impact of tuberculosis on minority populations in the 
United States. I would like to thank Congressmen Silvestre Reyes and 
Ciro Rodriguez for introducing this resolution.
  In particular, I would like to recognize the leadership of 
Congressman Sherrod Brown who has been an outspoken advocate for 
increased investment in tuberculosis treatment and prevention.
  In last year's Foreign Operations Appropriations bill, we worked 
together with Chairman Sonny Callahan to triple funding for 
international tuberculosis to $60 million. Although this was an 
important victory, we must do more to combat tuberculosis on a global 
level.
  Few diseases are as widespread and as devastating as TB. TB kills 2 
million people each year--and is second only to AIDS as the biggest 
infectious killer of adults in the world. TB will kill more people this 
year than any other year in history.
  TB is also the leading cause of death among people with HIV. It 
accounts for one-third of AIDS deaths worldwide and up to 40 percent of 
AIDS deaths in Africa and Asia.
  In the United States, TB rates are substantially higher for 
minorities than Caucasians. African Americans suffer from TB at a rate 
of eight times greater, Latinos at a rate of six times greater, and 
Asians at a rate of nearly fifteen times greater.
  The good news is that an effective treatment does exist for TB. The 
World Bank has reported that DOTS (Directly Observed Treatment 
Shortcourse)--is one of the most cost effective health interventions 
available. It costs just $20-$100 to save a life. The problem is that 
only one in five of those ill with TB is receiving treatment.
  We have a very small window of opportunity during which stopping TB 
would be cost effective. If we go too slowly, so much drug resistant TB 
will emerge that it will cost billions to control, with no guarantee of 
success.
  I enthusiastically support this resolution and working to ensure that 
Congress provides adequate funding to treat and prevent this terrible 
disease.
  Mrs. MINK of Hawaii. Madam Speaker, I rise in strong support of H. 
Res. 67, which recognizes the importance of combating tuberculosis on a 
worldwide basis, and acknowledging the impact that TB has had on the 
United States minority population.
  Hawaii's location, population and visitor profile makes for a unique 
role in infectious disease developments throughout the Pacific Basin 
and Asia. Unfortunately, Hawaii has the distinction of having the 
highest rate of TB among the 50 States. Eighty percent of TB cases 
occur among the foreign-born. Most of

[[Page H969]]

these cases occur in immigrants within five years of arrival into the 
State.
  The State of Hawaii Department of Health Tuberculosis Control Program 
works closely with the United States Public Health Service Honolulu 
Quarantine Station (USPHS HQS) to identify communicable diseases such 
as tuberculosis. The USPHS HQS has been responsible for the 
identification of communicable TB cases in immigrants that would not 
have been detected in their native country.
  This partnership has been threatened due to recent staff cuts at the 
USPHS HQS. More quarantine officers are desperately needed to provide 
protection to the residents of Hawaii and the rest of the United 
States.
  I am hopeful that the passage of this resolution will remind 
Americans that we must work with all developing nations to combat this 
horrific disease. We must also keep all U.S. quarantine stations 
staffed at appropriate levels to limit the spread of TB in our country.
  I urge my colleagues to support this resolution.
  Mr. RODRIGUEZ. Madam Speaker, today I join my colleague from Texas 
[Silvestre Reyes] in order to recognize the need to fight Tuberculosis 
(TB) across the globe. To many Americans, this is a disease of the past 
or one that only exists in other countries, far from us. Unfortunately, 
it is neither gone nor far away. Today, TB remains a dangerous disease 
impacting 15 million in the United States. If we are to eliminate TB 
within our own borders, we must work to control TB on a world wide 
basis.
  Nearly 57 million Americans travel in any given year outside of the 
United States, approximately 1 million people legally immigrate to the 
United States, and millions of others travel here each year. This 
continuous movement across borders increases the possible spread of the 
disease and makes it an international public health threat. While the 
disease knows no borders, we within our borders can take action and 
recognize the need to combat tuberculosis globally.
  I am greatly concerned that one-third of new TB cases originate in 
the four Southwest border states of Texas, New Mexico, Arizona, and 
California, and that minorities are disproportionately hurt by this 
disease. Tuberculosis occurs along the border at twice the national 
average. In the United States, Latinos suffer from TB at a rate that is 
six times that of Anglos. African-Americans suffer from TB at a rate 
that is eight times that of Anglos.
  TB needs to be controlled now before it spreads uncontrollably, or 
worse yet, becomes resistant to treatments. For most of us it might 
seem a distant disease that few of us will encounter, but it is a real 
and threatening disease that can harm many in the United States if we 
do not take control measures now. I urge you to support this fight 
against tuberculosis and to support H. Res. 67.
  Mr. LANTOS. Madam Speaker, I yield back the balance of my time.
  Mr. BALLENGER. Madam Speaker, I yield back the balance of my time.
  The SPEAKER pro tempore (Mrs. Biggert). The question is on the motion 
offered by the gentleman from North Carolina (Mr. Ballenger) that the 
House suspend the rules and agree to the resolution, H. Res. 67, as 
amended.
  The question was taken.
  The SPEAKER pro tempore. In the opinion of the Chair, two-thirds of 
those present have voted in the affirmative.
  Mr. LANTOS. Madam Speaker, on that I demand the yeas and nays.
  The yeas and nays were ordered.
  The SPEAKER pro tempore. Pursuant to clause 8 of rule XX and the 
Chair's prior announcement, further proceedings on this motion will be 
postponed.

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