[Congressional Record Volume 151, Number 54 (Thursday, April 28, 2005)]
[Senate]
[Pages S4567-S4569]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

      By Mr. BROWNBACK (for himself, Ms. Landrieu, and Mr. Inhofe):
  S. 950. A bill to provide assistance to combat tuberculosis, malaria, 
and other infectious diseases, and for other purposes; to the Committee 
on Foreign Relations.
  Mr. BROWNBACK. Mr. President, today I have introduced a bill with my 
colleagues, the senior Senators from Louisiana and Oklahoma, called the 
Eliminate Neglected Disease Act of 2005. Neglected diseases are 
diseases that don't get much attention but nonetheless account for the 
vast majority of all deaths in the world: malaria, tuberculosis, acute 
respiratory infections, infectious diarrhea. For most of these 
diseases, our bilateral foreign assistance agency, USAID, is not 
funding direct interventions in communities using known, life-saving 
tools. The need for our bill could not be more urgent.
  Given the following, conditions have never been better for the U.S. 
to apply inexpensive, relatively simple interventions to save lives: 1. 
We know how to cure and/or prevent these diseases.
  2. Interventions, prevention and/or treatment are relatively cheap. 
Cure for malaria = $2. For TB = $11-15. One year of non-curative 
treatment for AIDS: $500-1,000.
  3. These diseases are responsible for the vast majority of deaths in 
the developing world, particularly among children and pregnant women. 
Malaria is the number one killer of kids and pregnant women in Africa, 
kills between 1-2 million people each year but makes about 500 million 
sick! Tuberculosis kills about 2 million people each year. Unlike with 
other diseases, people can not avoid infection with these killers by 
behavior change.
  4. Low-hanging fruit--these diseases are so cheap to control, even 
the modest budgets we have now could make a huge difference if they 
were spent wisely.
  Our bill focuses on the following programmatic reform: 1. Direct 
interventions: requires funding of activities that have a direct impact 
on sick people or people at risk of becoming sick. For some programs, 
this will require a shift of priority in budgets from indirect support 
and advice-giving consultants to actually funding medical treatment, 
commodity procurement, and disease control activities.
  2. Accountability: programs must measure performance and prove that 
they are saving lives. The bill establishes mechanisms to revise or 
terminate contracts that fail to save lives.
  3. Transparency: Every dollar that the agency awards to combat 
infectious diseases must be accounted for on a public web site, similar 
to the Global Fund's web site. All signed agreements are posted online, 
as well as progress reports documenting performance on required 
deliverables and indicators.
  4. Scientific and Clinical Integrity: The bill provides that 
clinical/medical and public health programs are overseen by the 
agencies of the Federal Government where the core competencies in 
clinical medicine and public health reside. For programs where the lack 
of clinical and scientific expertise has been particularly acute, a 
group of Federal and non-government medical and academic experts will 
provide scientific and medical oversight.
  5. Coordination and Priority-setting: Up to five Federal agencies are 
currently involved in international malaria and tuberculosis programs. 
The bill would provide for clearer lines of authority and coordination 
for these programs, and require a strategic planning process to ensure 
that programs operate according to a outcome-focused 5-year plan.
  The world community conquered smallpox. We have nearly conquered 
polio and guinea worm. When we acted in concert, we stopped SARS in its 
tracks a few years ago. If these diseases were killing our own citizens 
at

[[Page S4569]]

the rates they are killing people in poorer countries, we would put an 
end to it using the inexpensive, known methods, in short order. African 
children are just as precious as American and European children. To 
those who have been given much, much is expected. We will be held 
responsible for how we responded to this crisis. I hope my colleagues 
will join us in supporting this legislation.
                                 ______