[Congressional Record Volume 156, Number 118 (Thursday, August 5, 2010)]
[Senate]
[Pages S6886-S6887]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

      By Mr. KERRY:
  S. 3711. A bill to amend the Public Health Service Act to direct the 
Secretary of Health and Human Services to establish, promote, and 
support a comprehensive prevention, education, research, and medical 
management referral program for viral hepatitis infection that will 
lead to a marked reduction in the disease burden associated with 
chronic viral hepatitis and liver cancer; to the Committee on Health, 
Education, Labor, and Pensions.
  Mr. KERRY. Mr. President, a silent killer is loose in America. It 
contributes to the deaths of 15,000 and threatens the health of 5.3 
million Americans each year. It is more common than HIV/AIDS. It is the 
leading cause of liver cancer, which is on the rise and continues to be 
a fatal and costly disease. Yet it remains unrecognized as a serious 
threat to public health. This silent killer is viral hepatitis.
  That is why I am introducing the Viral Hepatitis and Liver Cancer 
Control and Prevention Act of 2010, which authorizes $600 million to 
develop a national strategy over the next five years to prevent and 
control Hepatitis B and C.
  Most people don't even know they have it until years later when it 
causes cancer or liver disease. We can help avoid such needless 
tragedies with prevention and surveillance programs and by educating 
Americans on the pervasive nature of Hepatitis B and Hepatitis C.
  In January, the Institute of Medicine, IOM, released a report 
entitled ``Hepatitis and Liver Cancer.'' The report concludes that the 
current approach toward treating hepatitis is not working. Too many 
Americans at-risk for hepatitis or living with it do not know it and 
too many health providers are not screening for it. That should come as 
no surprise because there is no Federal funding of core public health 
services for viral hepatitis. Also, there is no federally funded 
chronic Hepatitis B and C surveillance system.
  The IOM report calls for a national strategy to prevent and control 
Hepatitis B and C.
  Hepatitis B is 100 times more infectious than HIV and, left 
untreated, can cause liver disease, liver cancer and premature death 
decades after infection. About 2 billion people worldwide have been 
infected with Hepatitis B and about 170 million people are chronically 
infected with Hepatitis C. Tragically, \2/3\ of those infected, on 
average, are unaware of their status, which increases the chance of 
spreading the disease.
  Dr. Howard Koh, Assistant Secretary of Health, has convened a task 
force including representatives from all Department of Health and Human 
Services agencies to develop an action plan to implement the 
recommendations of the Institute of Medicine Report.
  Unless action is taken to prevent chronic Hepatitis B and Hepatitis 
C, thousands more Americans will die each year from liver cancer or 
liver disease related to these preventable diseases.
  The Viral Hepatitis and Liver Cancer Control and Prevention Act 
directs the Secretary of Health and Human Services to develop a 
national plan for the prevention, control and medical management of 
viral hepatitis in coordination with the Centers for Disease Control 
and Prevention, CDC, the National Institutes for Health, the National 
Cancer Institute, NCI, the Health Resources and Services 
Administration, the Substance Abuse and Mental Health Services 
Administration, SAMHSA, the Agency for Healthcare Research and Quality 
and the Department of Veterans Affairs.
  The national plan is required to include the following components: 
education and awareness programs; an expansion of current vaccination 
programs; counseling regarding the ongoing risk factors associated with 
viral hepatitis; support for medical evaluation and ongoing medical 
management; increased support for adult viral hepatitis coordinators; 
and the establishment of an epidemiological surveillance program to 
identify trends in incidence and prevalence in the disease.
  The Viral Hepatitis and Liver Cancer Control and Prevention Act of 
2010 also

[[Page S6887]]

enhances SAMHSA's role in hepatitis activities by providing the agency 
with the authority to develop educational materials and intervention 
strategies to reduce the risks of hepatitis among substance abusers and 
individuals with mental illness.
  It authorizes nearly $600 million over the next five years to fund 
the national strategy to prevent and control viral hepatitis.
  I believe this investment in hepatitis control and prevention could 
save our country billions of dollars in the coming years. The baby 
boomer population is estimated to account for two out of every three 
cases of chronic Hepatitis C. As these Americans age into Medicare they 
are likely to develop complications and require expensive medical 
interventions at great cost to taxpayers. In the next decade, the costs 
of Hepatitis C to commercial insurance and Medicare will more than 
double, and within 20 years Medicare costs will increase five-fold. 
Projecting further out, over the next 20 years, total medical costs for 
patients with Hepatitis C infection could increase more than 2.5 
times--from $30 billion to more than $85 billion.
  However, the costs for early detection and intervention are 
dramatically less than the costs for treatment post-infection. The 
costs for Hepatitis B vaccinations vary but range from $75 to $165, 
whereas treatment can cost up to $16,000 per year. Screening for 
Hepatitis C is also relatively inexpensive compared to treatment that 
can cost up to $25,000 per year. Untreated, these infections will 
develop into liver disease that can cost up to $110,000 per hospital 
admission. We can do better.
  Viral hepatitis is an increasingly significant issue for 
Massachusetts. The Massachusetts Department of Public Health reports 
over 2,000 cases of newly diagnosed chronic Hepatitis B infection and 
8,000 to 10,000 cases of newly diagnosed chronic Hepatitis C infection 
each year. Viral hepatitis infections are by far the highest volume of 
reportable infectious diseases to the state. Additionally, there has 
been and continues to be a striking increase of cases of Hepatitis C 
infection among adolescents and young adults in the state. The 
Department of Public Health has received reports on over 1,000 cases in 
people under the age of 25 years every year since 2007, indicating that 
there is a new epidemic of Hepatitis C disease.
  Resources to address these complex problems have been extremely 
limited. Federal resources are scarce with the average award per state 
of $90,000 from the Division of Viral Hepatitis at CDC. That is less 
than the cost of one hospital admission for liver disease.
  The Massachusetts State Legislature has, until recently, provided 
modest funding to support Hepatitis C initiatives in the state. At this 
time, all of that funding, $1.4 million annually for the past several 
years, has been eliminated due to the ongoing fiscal crisis. However, 
past funding has allowed Massachusetts to develop innovative programs 
in many areas.
  State funds have supported disease surveillance initiatives so that 
changes in the epidemics can be detected, such as the increase of cases 
of Hepatitis C infection among young people or to identify cases of 
viral hepatitis that are being transmitted through non-sterile 
practices in health care settings. Disease surveillance programs have 
been used to identify women of childbearing age that are infected with 
Hepatitis B so that transmission to their babies can be prevented.
  The Viral Hepatitis and Liver Cancer Control and Prevention Act of 
2010 would provide critical assistance to Massachusetts and other 
states by starting to provide appropriate levels of funding to address 
these epidemics of disease.
  In Massachusetts, funding would be used to expand disease 
surveillance efforts so that we can better understand the impact of 
these infections and direct services appropriately to highly impacted 
communities. It would help to expand screening and educational services 
to help identify the large numbers of people in the state living with 
Hepatitis B and C that have not been identified. It would provide 
support to address the complex prevention needs of adolescents and 
young adults who are using drugs and at-risk for infection.
  Increased funding for adult immunization would assist the State in 
better targeting and providing Hepatitis B vaccine to the adults at 
highest risk, including those that are incarcerated and being treated 
for drug abuse. Finally, it would also help to provide essential 
medical management for people already infected with Hepatitis B and C 
who are not able to access appropriate care currently.
  I would like to thank a number of organizations who have been 
integral to the development of the Viral Hepatitis and Liver Cancer 
Control and Prevention Act of 2010. I am pleased that 102 hepatitis 
focused organizations from across the Nation have endorsed the 
legislation, including the National Viral Hepatitis Roundtable, 
National Alliance of State and Territorial AIDS Directors, NASTAD, the 
Hepatitis B Foundation, the Hepatitis C Association, American 
Association for the Study of Liver Disease, and the Hepatitis Education 
Project.
  We have no time to waste. This legislation, along with strategic 
investments in public health and prevention programs, can save billions 
of hard earned taxpayer dollars. It can improve the quality of life for 
tens of thousands of people all over America. I urge my colleagues to 
support activities that promote early detection and education and to 
cosponsor this important legislation.
                                 ______