III 

117TH CONGRESS 

1ST SESSION S. RES. 137 

Supporting the goals of World Tuberculosis Day to raise awareness about 

tuberculosis. 

IN THE SENATE OF THE UNITED STATES 

MARCH 25, 2021 

Mr. BROWN (for himself and Mr. SULLIVAN) submitted the following 

resolution; which was referred to the Committee on Foreign Relations 

RESOLUTION 

Supporting the goals of World Tuberculosis Day to raise 

awareness about tuberculosis. 

Whereas, in 2019, 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 10,000,000 people developed TB in 2019, 8.2 percent of whom were also 

infected with the human immunodeficiency virus (referred 

to in this preamble as ‘‘HIV’’); 

Whereas, in 2019, TB killed an estimated 1,408,000 people, 

causing more deaths worldwide than any other single infectious agent; 


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•SRES 137 IS 

Whereas, globally in 2019, an estimated 1,200,000 children 

developed TB, and in 2017, 230,000 children died of TB; 

Whereas 2⁄3 of new TB infections in 2019 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 208,000 people with HIV died of TB in 2019; 

Whereas vulnerable populations also at high risk for developing TB include individuals who are pregnant and 

newborns; 

Whereas, in 2018, TB was one of the 6 leading causes of 

death among adult women between the ages of 15 and 

49 in low-income countries; 

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; 


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Whereas, in 2019, according to the 2020 WHO Global Tuberculosis Report, an estimated 3.3 percent of all new 

TB cases and 18 percent of previously treated cases were 

MDR–TB or rifampin-resistant TB; 

Whereas, in 2019, an estimated 465,000 people around the 

world developed MDR–TB or rifampin-resistant TB, yet 

only approximately 38 percent 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 2019, every WHO region reported XDR–TB 

cases; 

Whereas, in 2019, 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 $178,000, and 

the average cost of treating a patient with XDR–TB was 

even higher at $553,000, compared with $20,000 to treat 

a patient with drug-susceptible TB; 

Whereas, between 2005 and 2007, according to an analysis 

by CDC, MDR–TB and XDR–TB cases in the United 

States collectively cost the health care system an estimated $53,000,000; 

Whereas CDC estimates that costs resulting from all forms 

of TB in the United States totaled more than 

$608,000,000 in 2019; 

Whereas, in a 2000 report, the Institute of Medicine found 

that a decrease in TB control funding and the spread of 


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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 8,916 TB cases were reported in the 

United States in 2019, 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 75 percent of States have reported an increase in 

the proportion of complex cases of TB in recent years 

due to factors such as homelessness, HIV infection, drug 

resistance, substance abuse, refugee status, and other 

factors; 

Whereas the rate of TB disease in African Americans is 8 

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 88 percent of all 

reported TB cases in the United States in 2019 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 an MDR–TB 

patient’s chance of survival from approximately 50 percent to as much as 80 percent, and through a public-priVerDate Sep 11 2014 18:27 Mar 26, 2021 Jkt 019200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6300 E:\BILLS\SR137.IS SR137

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vate 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 in 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— 


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(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 TBrelated 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 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; 


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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 73 percent of all international 

financing for TB programs; 

Whereas, in 2019, Global Fund-supported programs detected 

and treated more than 5,700,000 cases of TB; 

Whereas the coronavirus disease 2019 (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, 2021, 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 

1 Resolved, That the Senate— 


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1 (1) supports the goals of World Tuberculosis 

2 Day to raise awareness about tuberculosis; 

3 (2) commends the progress of tuberculosis 

4 elimination efforts by entities that include the 

5 United States Agency for International Develop6 ment, the Centers for Disease Control and Preven7 tion, the National Institutes of Health, the World 

8 Health Organization, and the Global Fund to Fight 

9 AIDS, Tuberculosis and Malaria; and 

10 (3) reaffirms the commitment to strengthen the 

11 leadership role of the United States in, and the ef12 fectiveness of the global response to, the fight to end 

13 the tuberculosis epidemic. 

Æ 


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