[Congressional Record Volume 156, Number 71 (Wednesday, May 12, 2010)]
[House]
[Pages H3420-H3421]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]
COMMENDING PROGRESS MADE BY ANTI-TUBERCULOSIS PROGRAMS
Mr. ENGEL. Mr. Speaker, I move to suspend the rules and agree to the
resolution (H. Res. 1155) commending the progress made by anti-
tuberculosis programs, as amended.
The Clerk read the title of the resolution.
The text of the resolution is as follows:
H. Res. 1155
Whereas tuberculosis (hereafter in this preamble referred
to as ``TB'') is the second leading fatal global infectious
disease behind HIV/AIDS, claiming 1,800,000 million lives
each year;
Whereas the global TB pandemic and the spread of drug
resistant TB present a persistent public health threat to the
United States;
Whereas according to 2009 data of the World Health
Organization, 5 percent of all new TB cases are drug
resistant;
Whereas TB is the leading killer of people with HIV/AIDS;
Whereas TB is the third leading killer of adult women, and
the stigma associated with TB disproportionately affects
women, causing them to delay seeking care and interfering
with treatment adherence;
Whereas the Institute of Medicine (IOM) found that the
resurgence of TB between 1980 and 1992 was caused by cuts in
TB control funding and the spread of HIV/AIDS;
Whereas, although the numbers of TB cases in the United
States continue to decline, progress towards TB elimination
has slowed, and it is a disease that does not recognize
borders;
Whereas New York City had to spend over $1,000,000,000 to
control a multi-drug resistant TB outbreak between 1989 and
1993;
Whereas an extensively drug resistant form of TB, known as
XDR-TB (hereafter referred to in this preamble as ``XDR-
TB)''), is very difficult and expensive to treat and has high
and rapid fatality rates, especially among HIV/AIDS patients;
Whereas the United States has had more than 83 cases of
XDR-TB over the last decade;
Whereas the Centers for Disease Control and Prevention
estimated in 2009 that it costs $483,000 to treat a single
case of XDR-TB;
Whereas African Americans are 8 times more likely to have
TB than Caucasians, and significant disparities exist among
other United States minorities, including Native Americans,
Asian Americans, and Hispanic Americans;
Whereas, although drugs, diagnostics and vaccines for TB
exist, these technologies are antiquated and are increasingly
inadequate for controlling the global epidemic;
Whereas the most commonly used TB diagnostic in the world,
sputum microscopy, is more than 100 years old and lacks
sensitivity to detect TB in most HIV/AIDS patients and in
children;
Whereas current tests to detect drug resistance take at
least 1 month to complete and faster drug susceptibility
tests must be developed to stop the spread of drug resistant
TB;
Whereas the TB vaccine, BCG, provides some protection to
children, but has little or no efficacy in preventing
pulmonary TB in adults;
Whereas there is also a critical need for new TB drugs that
can safely be taken concurrently with antiretroviral therapy
for HIV;
Whereas enactment of the Tom Lantos and Henry J. Hyde
United States Global Leadership Against HIV/AIDS,
Tuberculosis, and Malaria Reauthorization Act of 2008 and the
Comprehensive TB Elimination Act provide an historic United
States commitment to the global eradication of TB, including
to the successful treatment of 4,500,000 new TB patients and
90,000 new multi-drug resistant (MDR) TB cases by 2013, while
providing additional treatment through coordinated
multilateral efforts;
Whereas the United States Agency for International
Development provides financial and technical assistance to
nearly 40 highly-burdened TB countries and supports the
development of new diagnostic and treatment tools, and is
authorized to support research to develop new vaccines to
combat TB;
Whereas the Centers for Disease Control and Prevention,
working in partnership with States and territories of the
United States, directs the national TB elimination program
and essential national TB surveillance, technical assistance,
prevention activities and supports the development of new
diagnostic, treatment and prevention tools to combat TB;
Whereas the National Institutes of Health, through its many
institutes and centers, plays the leading role in basic and
clinical research into the identification, treatment and
prevention of TB;
Whereas the Global Fund to Fight AIDS, Tuberculosis and
Malaria provides 63 percent of all international financing
for TB programs worldwide and finances proposals worth
$3,200,000,000 in 112 countries, and TB treatment for
6,000,000 and HIV/TB services for 1,800,000, and in many
countries in which the Global Fund supports programs, TB
prevalence is declining, as are TB mortality rates; and
Whereas March 24, 2010, is World Tuberculosis Day, a day
that commemorates the date in 1882 when Dr. Robert Koch
announced
[[Page H3421]]
his discovery of Mycobacterium tuberculosis, the bacteria
that causes tuberculosis: Now, therefore, be it
Resolved, That the House of Representatives--
(1) supports the goals of World TB Day to raise awareness
about tuberculosis;
(2) commends the progress made by United States-led anti-
tuberculosis programs; and
(3) reaffirms its commitment to global tuberculosis control
made through the Tom Lantos and Henry J. Hyde United States
Global Leadership Against HIV/AIDS, Tuberculosis, and Malaria
Reauthorization Act of 2008.
The SPEAKER pro tempore. Pursuant to the rule, the gentleman from New
York (Mr. Engel) and the gentlewoman from Florida (Ms. Ros-Lehtinen)
each will control 20 minutes.
The Chair recognizes the gentleman from New York.
General Leave
Mr. ENGEL. Mr. Speaker, I ask unanimous consent that all Members may
have 5 legislative days to revise and extend their remarks and include
extraneous material on the resolution under consideration.
The SPEAKER pro tempore. Is there objection to the request of the
gentleman from New York?
There was no objection.
Mr. ENGEL. Mr. Speaker, I yield myself as much time as I may consume.
Mr. Speaker, this is my resolution, and I am proud to be the lead
sponsor of it. And I rise today in honor of this resolution to fight
tuberculosis, which I introduced with my good friends from Texas, Ted
Poe and Gene Green.
House Resolution 1155 seeks to commend the progress made by U.S.
anti-tuberculosis programs at the CDC, USAID, NIH and Global Fund to
Fight AIDS, Tuberculosis and Malaria, and to reaffirm the House's
historic commitment to global TB control made through the Lantos-Hyde
Act enacted 2 years ago. My own legislation, the Stop Tuberculosis Now
Act, was folded into the PEPFAR reauthorization, and I remain grateful
to Chairman Berman and Ranking Member Ros-Lehtinen, the gentlewoman
from Florida, for their strong support of this significant investment
in tuberculosis control. The chairman of the Subcommittee on Africa and
Global Health, Mr. Payne, is also to be commended for his commitment to
tuberculosis control as well.
Mr. Speaker, TB is the second leading global infectious disease
killer behind HIV-AIDS, claiming approximately 1.8 million lives each
year.
TB is the leading killer of people with HIV-AIDS. TB control must be
strengthened as part of a comprehensive approach to women's health. TB
is the third leading killer of adult women globally, and women who
develop the disease are more likely to die from it than men. The risk
of premature birth or having a low birth weight baby double for women
with TB, and those who receive a late diagnosis are four times as
likely to die in childbirth.
Mr. Speaker, about half a million people fall ill each year with
multidrug-resistant TB, but the World Health Organization estimates
that less than 5 percent are receiving appropriate treatment, which is
one of the factors fueling the spread of drug-resistant tuberculosis.
Although the number of TB cases in the United States is declining,
the nature of this infectious disease presents a persistent public
health threat to the United States. Tuberculosis is a significant
public health program for the border States of California, Texas, New
York, Florida and others.
Drug-resistant TB poses a particular challenge to domestic TB control
owing to the high costs of treatment and intensive health care
resources required. Treatment costs for multidrug-resistant TB range
from $100,000 to $300,000 per person, which can cause a significant
strain on State public health budgets. In 2008, 107 cases of MDR-TB
were reported in the United States. Of particular concern is that four
extensively drug-resistant TB cases were reported, double the number
from 2007.
H. Res. 1155 calls attention to the critical need for public and
private reinvestment into research to develop new TB diagnostics, drugs
and vaccines to replace antiquated technologies that hinder our
progress against tuberculosis.
Although drugs, diagnostics, and vaccines for TB exist, these
technologies are increasingly inadequate for controlling the global
epidemic. The most commonly used TB diagnostic in the world, sputum
microscopy, is more than 100 years old and lacks sensitivity to detect
TB in most HIV-AIDS patients and in children. The TB vaccine, BCG,
provides some protection to children, but has little or no effect in
preventing pulmonary TB in adults. We will never defeat TB without a
public and private research investment into new tuberculosis tools.
I urge my colleagues to vote in favor of H. Res. 1155, to be on
record in supporting the global fight against tuberculosis.
I reserve the balance of my time.
Ms. ROS-LEHTINEN. Mr. Speaker, I yield myself such time as I may
consume.
I am pleased to rise in support of the gentleman's resolution.
Tuberculosis is truly a significant challenge for all of us. It is a
disease that respects no borders, that claims the lives of over 1.8
million lives worldwide every year, and that continues to cause
needless deaths every day. It is a major threat to peoples living in
developing countries, but it is also a health risk here in the United
States and in other developed countries.
As this resolution correctly points out, drug therapies that are
currently used to treat tuberculosis are proving less and less
effective as new and different strains of tuberculosis continue to
build and develop resistance to these drugs.
There are about 9.4 million new cases of tuberculosis each year. In
addition, according to recent news reports, it is estimated that
440,000 people worldwide have been infected with deadly multidrug-
resistant tuberculosis in 2008 alone.
Just recently, the World Health Organization released a report that
underlined the continuing threat from the spread of drug-resistant
forms of tuberculosis.
Furthermore, as statistics reported by the World Health Organization
note, parts of Africa face a truly staggering threat, due to the large
numbers of those suffering from AIDS in those regions who are extremely
vulnerable to tuberculosis. In such regions, tuberculosis can indeed be
a fatal sentence of rapid and painful death.
The standard drug regimen for tuberculosis is severely outdated. With
current treatment methods, patients treated for tuberculosis have to
stay on medication for far too long, and that means that there can be
lapses in medication that only feed resistance among strains of the
disease. And so, new forms of treatment, new forms of therapies, and
new vaccines are needed. But what is needed also at a fundamental level
is the continued recognition of the dangerous nature of this disease
and the commitment to continue the struggle against it.
I thank my colleagues, the gentleman from New York (Mr. Engel), my
good friend, and the gentleman from Texas (Mr. Poe) for introducing
this important resolution. Its adoption by this House should reinforce
the message that we will continue to support the vital efforts to fight
this disease.
Mr. Speaker, I have no further requests for time, so I yield back the
balance of my time.
Mr. ENGEL. Mr. Speaker, before I yield back the balance of my time, I
want to thank my good friend, Congresswoman Ros-Lehtinen, who has
partnered with me in so much good legislation through the years. And I
really do appreciate her support.
I yield back the balance of my time.
The SPEAKER pro tempore. The question is on the motion offered by the
gentleman from New York (Mr. Engel) that the House suspend the rules
and agree to the resolution, H. Res. 1155, as amended.
The question was taken; and (two-thirds being in the affirmative) the
rules were suspended and the resolution, as amended, was agreed to.
A motion to reconsider was laid on the table.
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