II

107TH CONGRESS

1ST SESSION S. 1116

To amend the Foreign Assistance Act of 1961 to provide increased foreign

assistance for tuberculosis prevention, treatment, and control.

IN THE SENATE OF THE UNITED STATES

JUNE 27, 2001

Mr. INOUYE (for himself, Mr. STEVENS, Mr. KENNEDY, Mrs. HUTCHISON,

and Mr. CORZINE) introduced the following bill; which was read twice and

referred to the Committee on Foreign Relations

A BILL

To amend the Foreign Assistance Act of 1961 to provide

increased foreign assistance for tuberculosis prevention,

treatment, and control.

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled,

3 SECTION 1. SHORT TITLE.

4 This Act may be cited as the ‘‘Stop Tuberculosis

5 (TB) Now Act’’.

6 SEC. 2. FINDINGS.

7 Congress finds the following:

8 (1)(A) Tuberculosis is one of the greatest infec9 tious causes of death of adults worldwide, killing
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1 2,000,000 people per year—one person every 15 sec2 onds.

3 (B) Globally, tuberculosis is the leading cause

4 of death of young women and the leading cause of

5 death of people with HIV/AIDS.

6 (2) An estimated 8,000,000 individuals develop

7 active tuberculosis each year.

8 (3) Tuberculosis is spreading as a result of in9 adequate treatment and it is a disease that knows

10 no national borders.

11 (4) With over 40 percent of tuberculosis cases

12 in the United States attributable to foreign-born in13 dividuals and with the increase in international trav14 el, commerce, and migration, elimination of tuber15 culosis in the United States depends on efforts to

16 control the disease in developing countries.

17 (5) The threat that tuberculosis poses for

18 Americans derives from the global spread of tuber19 culosis and the emergence and spread of strains of

20 multi-drug resistant tuberculosis (MDR–TB).

21 (6) Up to 50,000,000 individuals may be in22 fected with multi-drug resistant tuberculosis.

23 (7) In the United States, tuberculosis treat24 ment, normally about $2,000 per patient, skyrockets

25 to as much as $250,000 per patient to treat multi-
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1 drug resistant tuberculosis, and treatment may not

2 even be successful.

3 (8) Multi-drug resistant tuberculosis kills more

4 than one-half of those individuals infected in the

5 United States and other industrialized nations and

6 without access to treatment it is a virtual death sen7 tence in the developing world.

8 (9) There is a highly effective and inexpensive

9 treatment for tuberculosis. Recommended by the

10 World Health Organization as the best curative

11 method for tuberculosis, this strategy, known as di12 rectly observed treatment, short course (DOTS), in13 cludes low-cost effective diagnosis, treatment, moni14 toring, and recordkeeping, as well as a reliable drug

15 supply. A centerpiece of DOTS is observing patients

16 to ensure that they take their medication and com17 plete treatment.

18 SEC. 3. ASSISTANCE FOR TUBERCULOSIS PREVENTION,

19 TREATMENT, AND CONTROL.

20 (a) ADDITIONAL PREVENTION, TREATMENT, AND

21 CONTROL.—Section 104(c)(7)(A) of the Foreign Assist22 ance Act of 1961 (22 U.S.C. 2151b(c)(7)(A)) is

23 amended—

24 (1) in clause (i), by adding at the end before

25 the semicolon the following: ‘‘, by expanding the use
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1 of the strategy known as directly observed treat2 ment, short course (DOTS) and strategies to ad3 dress multi-drug resistant tuberculosis (MDR–TB)

4 where appropriate at the local level, particularly in

5 countries with the highest rate of tuberculosis’’; and

6 (2) in clause (ii)—

7 (A) by inserting after ‘‘the cure of at least

8 95 percent of the cases detected’’ the following:

9 ‘‘by focusing efforts on the use of the directly

10 observed treatment, short course (DOTS) strat11 egy or other internationally accepted primary

12 tuberculosis control strategies’’; and

13 (B) by striking ‘‘and the cure’’ and insert14 ing ‘‘the cure’’.

15 (b) FUNDING REQUIREMENT.—Section 104(c)(7) of

16 the Foreign Assistance Act of 1961 (22 U.S.C.

17 2151b(c)(7)) is amended—

18 (1) by redesignating subparagraph (B) as sub19 paragraph (C); and

20 (2) by inserting after subparagraph (A) the fol21 lowing:

22 ‘‘(B) In carrying out this paragraph, not less than

23 75 percent of the amount appropriated pursuant to the

24 authorization of appropriations under subparagraph (D)

25 shall be used for the diagnosis and treatment of tuber-
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1 culosis for at-risk and affected populations utilizing di2 rectly observed treatment, short course (DOTS) strategy

3 or other internationally accepted primary tuberculosis con4 trol strategies developed in consultation with the World

5 Health Organization (WHO), including funding for the

6 Global Tuberculosis Drug Facility of WHO’s Stop TB

7 Partnership.’’.

8 (c) ANNUAL REPORT.—Section 104(c)(7) of the For9 eign Assistance Act of 1961 (22 U.S.C. 2151b(c)(7)) is

10 amended—

11 (1) by redesignating subparagraph (C) (as re12 designated by this Act) as subparagraph (D); and

13 (2) by inserting after subparagraph (B) the fol14 lowing:

15 ‘‘(C) In conjunction with the transmission of the an16 nual request for enactment of authorizations and appro17 priations for foreign assistance programs for each fiscal

18 year, the President shall transmit to Congress a report

19 that contains a summary of all programs, projects, and

20 activities carried out under this paragraph for the pre21 ceding fiscal year, including a description of the extent to

22 which such programs, projects, and activities have made

23 progress to achieve the goals described in subparagraph

24 (A)(ii).’’.
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1 (d) AUTHORIZATION OF APPROPRIATIONS.—Sub2 paragraph (D) of section 104(c)(7) of the Foreign Assist3 ance Act of 1961 (22 U.S.C. 2151b(c)(7)), as redesig4 nated by this Act, is amended by striking ‘‘$60,000,000

5 for each of the fiscal years 2001 and 2002’’ and inserting

6 ‘‘$60,000,000 for fiscal year 2001 and $200,000,000 for

7 fiscal year 2002’’.

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