[Congressional Record (Bound Edition), Volume 156 (2010), Part 6]
[House]
[Pages 8053-8055]
[From the U.S. 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;

[[Page 8054]]

       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 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.

[[Page 8055]]

  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.
  Mr. GENE GREEN of Texas. Mr. Speaker, I rise today in support of H. 
Res. 1155, commending the progress made by anti-tuberculosis programs.
  Tuberculosis is the second leading global infectious disease killer 
behind HIV/AIDS, claiming approximately 1.8 million lives each year. It 
is estimated that \1/3\ of the world's population is infected with TB. 
This disease kills people of all races and ages around the world.
  The global TB pandemic and spread of drug resistant TB presents a 
persistent public health threat to the U.S. The WHO reports that 5 
percent of all new TB cases are drug resistant, with estimates of up to 
28 percent drug resistant reported in some parts of Russia. Of these 
numbers, it is estimated that only 7 percent are receiving treatment.
  Although drugs, diagnostics and vaccines for TB exist, these 
technologies are antiquated and 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.
  Drug susceptibility tests for drug resistant TB take 2-4 weeks to 
complete, during which time a drug resistant TB patient in a developing 
country may die. The TB vaccine, BCG, provides some protection to 
children, but has little or no efficacy in preventing pulmonary TB in 
adults. We will never be able to defeat TB without the introduction of 
new identification, treatment and prevention tools.
  World TB Day also provides us with an opportunity to celebrate the 
significant gains made in the fight against TB and reminds us of the 
challenges ahead. Since 1995, 36 million people around the world have 
successfully been treated for TB and 9 million lives have been saved.
  Less than 2 years ago, this Congress passed two historic laws to 
combat TB. The Comprehensive TB Elimination Act authorizes the tools to 
put the U.S. on the path to TB elimination and the Lantos-Hyde Act, 
with multilateral commitment, aims to reduce the global TB burden by 
half within a decade.
  Both of these laws would support an increased research investment to 
get us the new TB diagnostic, treatment and prevention tools that we 
urgently need. With enactment of these 2 laws, we have the power to 
combat TB effectively and reduce the human misery that this disease 
wreaks around the world.
  I want to commend Rep. Engel for his tremendous efforts on TB 
awareness and urge my colleagues to support H. Res. 1155.
  Mr. ENGEL. 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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