[Congressional Record Volume 147, Number 91 (Wednesday, June 27, 2001)]
[Senate]
[Page S7000]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

      By Mr. KENNEDY (for himself, Mr. Stevens, Mr. Inouye, Mrs. 
        Hutchison, and Mr. Corzine):
  S. 1115. A bill to amend the Public Health Service Act with respect 
to making progress toward the goal of eliminating tuberculosis, and for 
other purposes; to the Committee on Health, Education, Labor, and 
Pensions.
  Mr. KENNEDY. Mr. President, it is a privilege to join my colleagues 
Senator Stevens, Senator Inouye, Senator Hutchison, and Senator Corzine 
in introducing the Comprehensive Tuberculosis Elimination Act. This 
bipartisan legislation will provide enhanced authority and greater 
resources to State, local and Federal health officials to do all they 
can to combat this deadly infectious disease in our country.
  Tuberculosis is the world's leading infectious killer. Its growth has 
been propelled by the global HIV epidemic, and multi-drug resistant 
strains have become increasingly prevalent around the world. The World 
Health Organization estimates that more than one-third of the world's 
population is infected with tuberculosis. Every year, there are 8 
million new cases of active tuberculosis and 2 million deaths from 
tuberculosis. This disease causes more deaths among women worldwide 
than all other causes of maternal death combined.
  These harrowing statistics illustrate the truth behind the saying 
that diseases know no borders. Senators Inouye, Stevens, and Hutchison 
and I have already introduced the Stop TB Now Act, which focuses on 
international tuberculosis control. The bill we are introducing today 
will deal with tuberculosis in our own country. Only through enactment 
of both of these measures can we be sure of defeating this readily 
treatable and preventable disease.
  Today's bill is intended to fulfill the recommendations of the 
landmark report issued by the Institute of Medicine last year, entitled 
``Ending Neglect: The Elimination of Tuberculosis in the United 
States.'' Our measure will create a national plan for the eradication 
of tuberculosis. It will enhance tuberculosis-related research, 
education and training through the Centers for Disease Control and 
Prevention. It will also expand support for vaccine research and for 
international tuberculosis research through the National Institutes of 
Health.
  In the United States, tuberculosis has been going through what the 
Institute of Medicine calls ``recurrent cycles of neglect'' by public 
health authorities, ``followed by resurgence'' of the disease. In the 
late nineteenth century, tuberculosis was one of the leading causes of 
death in America. As cities swelled with waves of European immigration, 
millions of individuals and families were forced into overcrowded 
tenements and unhealthy workplaces. Many fell victim to outbreaks of 
deadly infectious diseases. In 1886, the leading cause of death among 
infants was tuberculosis, followed by infant diarrhea.
  Although medical science and public health were in their infancy in 
those days, the need to combat tuberculosis was clear even then. In 
1882, Robert Kock first isolated the organism that causes this disease, 
providing physicians and scientists with a microbial foundation for 
science-based public health action. In the early twentieth century, 
health advocates and physicians formed an association dedicated to 
fighting tuberculosis, which today is the American Lung Association. 
Their work helped to bring about more sanitary living conditions and 
workplaces for the poor, stronger public health laws, and the use of 
sanatoriums to treat people with tuberculosis.
  In this century, the possibility of actually eradicating tuberculosis 
arose following the development of effective antibiotics in the 1950s. 
But the country failed to capitalize on scientific opportunities or 
undertake the kind of broad public health campaign that we undertook so 
successfully against polio. As a result, scientific interest and public 
health funding for tuberculosis control waned in the following decades. 
After years of decline, specific Federal funding for tuberculosis 
control was actually eliminated in 1972.
  Our country paid the price for this complacency in the 1980s. A 
resurgence of cases and an alarming growth in the prevalence of drug-
resistant tuberculosis strains challenged public health and shook the 
confidence of experts. Through great effort and difficulty, we renewed 
our national commitment to fighting tuberculosis. But the effort took 
longer than necessary, and the Nation suffered needless deaths and 
illness as we worked to bring the number of new tuberculosis cases to 
its current, all-time low.
  Today, we have a historic opportunity to eradicate tuberculosis in 
the United States. We have a generation of public health officials who 
have lived through and successfully combated the recent resurgence of 
the disease. And we have expert recommendations from both the Federal 
Advisory Council for the Elimination of Tuberculosis and the Institute 
of Medicine to guide our efforts.
  This legislation is supported by leading public health organizations, 
including the American Lung Association, the American Thoracic Society, 
the National Coalition to Eliminate Tuberculosis and RESULTS 
International. Its enactment can be an essential in achieving to 
fulfilling this important and long overdue public health goal, and I 
urge the Senate to approve it.
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