[Congressional Record Volume 168, Number 56 (Wednesday, March 30, 2022)]
[Senate]
[Pages S1870-S1871]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]





 SENATE RESOLUTION 569--SUPPORTING THE GOALS OF WORLD TUBERCULOSIS DAY 
                 TO RAISE AWARENESS ABOUT TUBERCULOSIS

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

                              S. Res. 569

       Whereas, in 2020, nearly \1/4\ of the global population was 
     infected with the tuberculosis bacterium (referred to in this 
     preamble as ``TB'');
       Whereas the World Health Organization (referred to in this 
     preamble as the ``WHO'') estimates that 9,900,000 people 
     developed TB in 2020, 8 percent of whom were also infected 
     with the human immunodeficiency virus (referred to in this 
     preamble as ``HIV'');
       Whereas, in 2020, TB killed an estimated 1,514,000 people, 
     second only to coronavirus disease 2019 (referred to in this 
     preamble as ``COVID-19'') as a leading cause of death from a 
     single infectious agent;
       Whereas, globally in 2020, an estimated 1,100,000 children 
     developed TB, and in 2020, 228,972 children died of TB;
       Whereas \2/3\ of new TB infections in 2020 occurred in 8 
     countries: India, Indonesia, China, the Philippines, 
     Pakistan, Nigeria, Bangladesh, and South Africa;
       Whereas TB is a leading killer of people infected with HIV, 
     and 214,000 people with HIV died of TB in 2020;
       Whereas vulnerable populations also at high risk for 
     developing TB include individuals who are pregnant and 
     newborns;
       Whereas, in 2020, TB was the 13th leading cause of death;
       Whereas, in some settings, women with TB can face stigma, 
     discrimination, and ostracization by their families and 
     communities;
       Whereas the global TB epidemic and the spread of drug-
     resistant TB present a persistent public health threat to the 
     United States because the disease does not recognize borders;
       Whereas antibiotic-resistant pathogens are a growing 
     problem worldwide, and drug-resistant TB can occur when the 
     drugs used to treat TB are mismanaged or not made 
     consistently accessible;
       Whereas studies have demonstrated direct person-to-person 
     transmission of drug-resistant TB;
       Whereas multi-drug resistant TB (referred to in this 
     preamble as ``MDR-TB'') is caused by bacteria with resistance 
     to rifampin and isoniazid, the 2 most potent treatments for 
     TB infection;
       Whereas, in 2020, according to the 2021 WHO Global 
     Tuberculosis Report, an estimated 3 to 4 percent of all new 
     TB cases and 18 to 21 percent of previously treated cases 
     were MDR-TB or rifampin-resistant TB;
       Whereas, in 2020, an estimated 297,000 people around the 
     world developed MDR-TB or rifampin-resistant TB, yet only 
     approximately 1 in 3 of those individuals were identified and 
     treated;
       Whereas extensively drug-resistant TB (referred to in this 
     preamble as ``XDR-TB'') is a rare type of TB that is 
     resistant to nearly all medicines, and therefore can be very 
     difficult and expensive to treat, especially among patients 
     with HIV;
       Whereas, in 2020, 25,681 cases of XDR-TB were reported;
       Whereas, in 2020, the Centers for Disease Control and 
     Prevention (referred to in this preamble as ``CDC'') 
     estimated that the average cost of treating a single patient 
     with MDR-TB in the United States was $182,186, and the 
     average cost of treating a patient with XDR-TB was even 
     higher at $567,708, compared with $20,211 to treat a patient 
     with drug-susceptible TB;
       Whereas, between 2005 and 2007, according to an analysis by 
     the CDC, MDR-TB and XDR-TB cases in the United States 
     collectively cost the health care system an estimated 
     $53,000,000;
       Whereas the CDC estimates that costs resulting from all 
     forms of TB in the United States totaled more than 
     $503,000,000 in 2020;
       Whereas, in a 2000 report, the Institute of Medicine found 
     that a decrease in TB control funding and the spread of HIV 
     and acquired immune deficiency syndrome (commonly referred to 
     as ``AIDS'') caused a resurgence of TB in the late 1980s and 
     early 1990s;
       Whereas a total of 7,174 TB cases were reported in the 
     United States in 2020, representing all 50 States and the 
     District of Columbia, and up to 13,000,000 people in the 
     United States are estimated to be living with latent TB 
     infection;
       Whereas the rate of TB disease in African Americans is 8.5 
     times higher than the rate of disease in White, non-Hispanic 
     Americans, and significant disparities exist among other 
     minorities in the United States, including Asian Americans, 
     Hispanic Americans, and Native Americans and Alaska Natives, 
     with approximately 89 percent of all reported TB cases in the 
     United States in 2020 occurring in racial or ethnic 
     minorities;
       Whereas smoking--
       (1) greatly increases the risks of contracting TB and 
     infection recurrence; and
       (2) impairs therapeutic efficacy;
       Whereas diabetes is a major risk factor for TB, and people 
     with diabetes are more likely to develop and succumb to TB;
       Whereas bedaquiline is an antibiotic that boosts the chance 
     of survival for an MDR-TB patient from approximately 50 
     percent to as much as 80 percent, and through a public-
     private partnership, the United States Agency for 
     International Development (referred to in this preamble as 
     ``USAID'') provided approximately 105,000 treatments in 110 
     eligible countries from 2015 through 2019;
       Whereas Bacillus Calmette-Guerin, a TB vaccine that is 
     known as BCG, provides some protection to infants and young 
     children against serious forms of childhood TB but has had 
     little epidemiologic impact on controlling TB worldwide;
       Whereas there is a critical need for new drugs, 
     diagnostics, and vaccines for controlling the global TB 
     epidemic;
       Whereas, in September 2018, the United Nations held the 
     first high-level meeting on TB at which 120 countries, 
     including the United States, signed a political declaration 
     committing to accelerating the TB response, including by 
     increasing funding for TB control programs and research and 
     development efforts, with the goal of reaching all affected 
     people with TB prevention and care;
       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) led to a historic United States commitment to 
     support the global eradication of TB, including a commitment 
     to treat 4,500,000 TB patients and 90,000 MDR-TB patients 
     between 2009 and 2013 and to provide additional treatment 
     through coordinated multilateral efforts;
       Whereas USAID--
       (1) provides technical assistance to 55 countries and 
     implements bilateral programs in 23 high-burden TB countries 
     that--
          (A) build capacity; and
          (B) support the adoption of state-of-the-art TB-related 
     technologies;
       (2) supports the development of new diagnostic and 
     treatment tools; and
       (3) supports research to develop new vaccines and other new 
     methods to combat TB;
       Whereas, in 2018, USAID launched--
       (1) a new business model entitled ``Global Accelerator to 
     End Tuberculosis'' to accelerate progress and build capacity 
     with respect to TB prevention and treatment; and
       (2) a new mechanism to directly support local organizations 
     in priority countries;
       Whereas TB incidence in the countries that receive 
     bilateral TB funding from the United States through USAID has 
     decreased by more than 29 percent since 2000;
       Whereas, according to the Copenhagen Consensus Center, TB 
     prevention programs return $56 for each dollar invested, 
     which is one of the highest returns on investment of any 
     health intervention;
       Whereas the CDC, in partnership with other entities of the 
     United States and individual States and territories--
       (1) directs the national TB elimination program;
       (2) coordinates TB surveillance, technical assistance, and 
     prevention activities; and
       (3) helps to support 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 on the identification, treatment, and 
     prevention of TB;
       Whereas the Global Fund to Fight AIDS, Tuberculosis and 
     Malaria (referred to in this preamble as the ``Global 
     Fund''), to which the United States is a top financial donor, 
     provides more than 77 percent of all international financing 
     for TB programs;
       Whereas, in 2020, programs supported by the Global Fund 
     detected and treated more than 4,700,000 cases of TB;
       Whereas the COVID-19 pandemic and mitigation efforts put in 
     place as a result of the pandemic have taken a devastating 
     toll on countries with the highest burden of TB disease and 
     on the global TB response, threatening to reverse up to 8 
     years of progress fighting the disease;
       Whereas, in 2020, in the 23 high-burden TB countries in 
     which USAID implements bilateral programs, 1,000,000 fewer 
     people with TB had access to diagnosis and treatment, a 23 
     percent decline from 2019;
       Whereas, between 2020 and 2025, global projections estimate 
     that the impact of the COVID-19 pandemic will lead to an 
     additional 6,300,000 cases of TB and an additional 1,400,000 
     TB deaths; and
       Whereas March 24, 2022, is World Tuberculosis Day, a day 
     that commemorates the date in 1882 on which Dr. Robert Koch 
     announced his discovery of mycobacterium tuberculosis, the 
     bacterium that causes TB: 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 tuberculosis elimination 
     efforts by entities that include the United States Agency for 
     International Development, the Centers for Disease Control 
     and Prevention, the National Institutes of Health, the World 
     Health Organization, and the Global Fund to Fight AIDS, 
     Tuberculosis and Malaria; and
       (3) reaffirms the commitment to strengthen the leadership 
     role of the United States in, and the effectiveness of the 
     global response to, the fight to end the tuberculosis 
     epidemic.

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