[Congressional Record Volume 160, Number 46 (Monday, March 24, 2014)]
[Senate]
[Page S1694]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                         SUBMITTED RESOLUTIONS

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 SENATE RESOLUTION 393--SUPPORTING THE GOALS OF WORLD TUBERCULOSIS DAY 
                 TO RAISE AWARENESS ABOUT TUBERCULOSIS

  Mr. BROWN (for himself and Mr. Isakson) submitted the following 
resolution; which was referred to the Committee on Foreign Relations:

                              S. Res. 393

       Whereas 1/3 of the population of the world is infected with 
     the tuberculosis bacterium;
       Whereas more than 9,500 tuberculosis cases were reported in 
     the United States in 2013;
       Whereas more than 1,300,000 individuals die from 
     tuberculosis each year;
       Whereas over 95 percent of tuberculosis deaths occur in 
     low- and middle-income developing countries;
       Whereas tuberculosis is the second leading global 
     infectious disease killer, behind HIV/AIDS, and claims 
     1,800,000 lives each year;
       Whereas tuberculosis is a leading killer of people living 
     with HIV/AIDS, causing 1/5 of all deaths among people with 
     HIV/AIDS;
       Whereas tuberculosis is the third leading killer of adult 
     women, and the stigma associated with tuberculosis 
     disproportionately affects women, causing women to delay 
     seeking care and interfering with treatment adherence;
       Whereas the global tuberculosis pandemic and the spread of 
     drug-resistant tuberculosis present a persistent public 
     health threat to the United States;
       Whereas according to 2009 data from the World Health 
     Organization, 3.6 percent of all new tuberculosis cases are 
     drug resistant;
       Whereas multi-drug resistant tuberculosis (referred to in 
     this preamble as ``MDR-TB'') is present in virtually all 
     countries surveyed;
       Whereas approximately 450,000 people around the world 
     developed MDR-TB in 2012;
       Whereas extensively drug-resistant tuberculosis (referred 
     to in this preamble as ``XDR-TB'') is a strain of 
     tuberculosis that is very difficult and expensive to treat 
     and has high and rapid fatality rates, especially among HIV/
     AIDS patients;
       Whereas there have been more than 63 cases of XDR-TB in the 
     United States between 2004 and 2014;
       Whereas as of September 2013, 92 countries have reported at 
     least 1 case of XDR-TB;
       Whereas the Centers for Disease Control and Prevention 
     estimated, in 2009, that the cost of hospitalizing a single 
     patient with XDR-TB is $483,000;
       Whereas, between 2005 and 2007, the 373 XDR-TB cases in the 
     United States collectively cost the health care system an 
     estimated $53,000,000;
       Whereas the death rate of tuberculosis dropped 45 percent 
     between 1990 and 2012;
       Whereas the Institute of Medicine found that a decrease in 
     tuberculosis control funding and the spread of HIV/AIDS 
     caused the resurgence of tuberculosis between 1980 and 1992;
       Whereas although the number of tuberculosis cases in the 
     United States continues to decline, progress towards 
     eliminating tuberculosis has slowed and the disease does not 
     recognize borders;
       Whereas African Americans are 8 times more likely to have 
     tuberculosis than Caucasians, and significant disparities 
     exist among other minorities in the United States, including 
     Native Americans, Asian Americans, and Hispanic Americans;
       Whereas over 530,000 children became infected with 
     tuberculosis in 2012;
       Whereas tobacco use greatly increases the risk of 
     tuberculosis and death, and more than 20 percent of 
     tuberculosis cases worldwide attribute to smoking;
       Whereas diabetes is a major risk factor for tuberculosis, 
     and people with diabetes are more likely to develop the 
     disease and have a higher risk of death due to the disease;
       Whereas a new technology, known as Xpert, developed in the 
     United States, is able to diagnose cases of tuberculosis 
     within 2 hours, and such technology can even diagnose cases 
     that are difficult to detect, such as cases involving 
     individuals living with HIV;
       Whereas although drugs, diagnostics, and vaccines for 
     tuberculosis exist, these technologies are antiquated and 
     increasingly inadequate for controlling the global epidemic;
       Whereas Xpert can quickly detect resistance to 1 of the 
     primary tuberculosis drugs, but other tests to detect drug 
     resistance take at least 1 month to complete and the medical 
     community must develop even faster drug susceptibility tests 
     to stop the spread of drug-resistant tuberculosis;
       Whereas Bacillus Calmette-Guerin, a tuberculosis vaccine 
     that is known as ``BCG'', provides some protection to 
     children but has little or no efficacy in preventing 
     pulmonary tuberculosis in adults;
       Whereas there is a critical need for the development of 
     tuberculosis drugs that individuals can safely take 
     concurrently with antiretroviral therapy for HIV;
       Whereas the Millennium Development Goal of the World Health 
     Organization is to reverse the spread of tuberculosis by 
     2015;
       Whereas the enactment of the Tom Lantos and Henry J. Hyde 
     United States Global Leadership Against HIV/AIDS, 
     Tuberculosis, and Malaria Reauthorization Act of 2008 (Public 
     Law 110-293; 122 Stat. 2918) and the Comprehensive 
     Tuberculosis Elimination Act of 2008 (Public Law 110-392; 122 
     Stat. 4195) provides an historic United States commitment to 
     the global eradication of tuberculosis, including a 
     commitment to successfully treating 4,500,000 tuberculosis 
     patients and 90,000 MDR-TB patients between 2008 and 2013 and 
     to 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 tuberculosis countries, supports 
     the development of new diagnostic and treatment tools, and is 
     authorized to support research to develop new vaccines to 
     combat tuberculosis;
       Whereas the Centers for Disease Control and Prevention, 
     partnering with the other entities of the United States and 
     individual States and territories, directs the national 
     tuberculosis elimination program, directs essential national 
     tuberculosis surveillance, technical assistance, and 
     prevention activities, and supports the development of new 
     diagnostic, treatment, and prevention tools to combat 
     tuberculosis;
       Whereas the National Institutes of Health, through its many 
     institutes and centers, plays the leading role in basic and 
     clinical research on the identification, treatment, and 
     prevention of tuberculosis;
       Whereas the Global Fund to Fight AIDS, Tuberculosis, and 
     Malaria provides 63 percent of all international financing 
     for tuberculosis programs;
       Whereas the Global Fund to Fight AIDS, Tuberculosis, and 
     Malaria finances--
       (1) proposals worth $3,200,000,000 in 112 countries;
       (2) tuberculosis treatment for 6,000,000 people; and
       (3) 1,800,000 HIV/AIDS and tuberculosis services;

       Whereas the prevalence and mortality rates of tuberculosis 
     are declining in many countries with programs supported by 
     the Global Fund to Fight AIDS, Tuberculosis, and Malaria; and
       Whereas March 24, 2014, is World Tuberculosis Day, a day 
     that commemorates the date in 1882 on which Dr. Robert Koch 
     announced his discovery of Mycobacterium tuberculosis, the 
     bacteria that causes tuberculosis: Now, therefore, be it
       Resolved, That the Senate--
       (1) supports the goals of World Tuberculosis Day to raise 
     awareness about tuberculosis;
       (2) commends the progress of anti-tuberculosis efforts by 
     entities that include the United States Agency for 
     International Development, the Centers for Disease Control 
     and Prevention, the National Institutes of Health, and the 
     Global Fund to Fight AIDS, Tuberculosis, and Malaria; and
       (3) reaffirms the commitment to global tuberculosis control 
     set forth in section 4 of the United States Leadership 
     Against HIV/AIDS, Tuberculosis, and Malaria Act of 2003 (22 
     U.S.C. 7603).

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