I

107TH CONGRESS

1ST SESSION H. R. 1168

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

assistance for tuberculosis prevention, treatment, and control.

IN THE HOUSE OF REPRESENTATIVES

MARCH 22, 2001

Mr. BROWN of Ohio (for himself, Mrs. MORELLA, Mr. WAXMAN, Mr. ANDREWS, Mr. GANSKE, Ms. MCKINNEY, Mr. BACA, Mr. MORAN of Virginia, Mr. RODRIGUEZ, Mrs. TAUSCHER, Mr. OLVER, Mr. KILDEE, Mrs.

CAPPS, Mrs. WILSON, Mr. CARSON of Oklahoma, Mr. CAPUANO, Mr.

FROST, Mr. UDALL of Colorado, Mr. LEWIS of Georgia, Mr. GREEN of

Texas, Ms. BROWN of Florida, Ms. LOFGREN, Mr. SANDLIN, Mr. RANGEL, Ms. MCCARTHY of Missouri, and Mr. REYES) introduced the following bill; which was referred to the Committee on International 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’’.
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1 SEC. 2. FINDINGS.

2 Congress finds the following:

3 (1)(A) Tuberculosis is one of the greatest infec4 tious causes of death of adults worldwide, killing

5 2,000,000 people per year—one person every 15 sec6 onds.

7 (B) Globally, tuberculosis is the leading cause

8 of death of young women and the leading cause of

9 death of people with HIV/AIDS.

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

11 active tuberculosis each year.

12 (3) Tuberculosis is spreading as a result of in13 adequate treatment and it is a disease that knows

14 no national borders.

15 (4) With over 40 percent of tuberculosis cases

16 in the United States attributable to foreign-born in17 dividuals and with the increase in international trav18 el, commerce, and migration, elimination of tuber19 culosis in the United States depends on efforts to

20 control the disease in developing countries.

21 (5) The threat that tuberculosis poses for

22 Americans derives from the global spread of tuber23 culosis and the emergence and spread of strains of

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

25 (6) Up to 50,000,000 individuals may be in26 fected with multi-drug resistant tuberculosis.
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1 (7) In the United States, tuberculosis treat2 ment, normally about $2,000 per patient, skyrockets

3 to as much as $250,000 per patient to treat multi4 drug resistant tuberculosis, and treatment may not

5 even be successful.

6 (8) Multi-drug resistant tuberculosis kills more

7 than one-half of those individuals infected in the

8 United States and other industrialized nations and

9 without access to treatment it is a virtual death sen10 tence in the developing world.

11 (9) There is a highly effective and inexpensive

12 treatment for tuberculosis. Recommended by the

13 World Health Organization as the best curative

14 method for tuberculosis, this strategy, known as di15 rectly observed treatment, short course (DOTS), in16 cludes low-cost effective diagnosis, treatment, moni17 toring, and recordkeeping, as well as a reliable drug

18 supply. A centerpiece of DOTS is observing patients

19 to ensure that they take their medication and com20 plete treatment.

21 SEC. 3. ASSISTANCE FOR TUBERCULOSIS PREVENTION,

22 TREATMENT, AND CONTROL.

23 (a) ADDITIONAL PREVENTION, TREATMENT, AND

24 CONTROL.—Section 104(c)(7)(A) of the Foreign Assist-
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1 ance Act of 1961 (22 U.S.C. 2151b(c)(7)(A)) is

2 amended—

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

4 the semicolon the following: ‘‘, including by expand5 ing the use of the strategy known as directly ob6 served treatment, short course (DOTS) and strate7 gies to address multi-drug resistant tuberculosis

8 (MDR–TB) where appropriate at the local level, par9 ticularly in countries with the highest rate of tuber10 culosis’’; and

11 (2) in clause (ii)—

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

13 85 percent of the cases detected’’ the following:

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

15 observed treatment, short course (DOTS) strat16 egy or other internationally accepted primary

17 tuberculosis control strategies’’; and

18 (B)(i) by striking ‘‘and the cure’’ and in19 serting ‘‘the cure’’; and

20 (ii) by adding at the end before the period

21 the following: ‘‘, and the reduction of tuber22 culosis-related deaths by 50 percent, by Decem23 ber 31, 2010’’.
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1 (b) FUNDING REQUIREMENT.—Section 104(c)(7) of

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

3 2151b(c)(7)) is amended—

4 (1) by redesignating subparagraph (B) as sub5 paragraph (C); and

6 (2) by inserting after subparagraph (A) the fol7 lowing:

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

9 75 percent of the amount appropriated pursuant to the

10 authorization of appropriations under subparagraph (D)

11 shall be used for the diagnosis and treatment of tuber12 culosis or for direct patient services and anti-tuberculosis

13 drugs for at-risk and affected populations utilizing directly

14 observed treatment, short course (DOTS) strategy or

15 other internationally accepted primary tuberculosis control

16 strategies developed in consultation with the World Health

17 Organization (WHO), including the Global Tuberculosis

18 Drug Facility of WHO’s Stop TB Partnership.’’.

19 (c) ANNUAL REPORT.—Section 104(c)(7) of the For20 eign Assistance Act of 1961 (22 U.S.C. 2151b(c)(7)) is

21 amended—

22 (1) by redesignating subparagraph (C) (as re23 designated by this Act) as subparagraph (D); and

24 (2) by inserting after subparagraph (B) the fol25 lowing:
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1 ‘‘(C) In conjunction with the transmission of the an2 nual request for enactment of authorizations and appro3 priations for foreign assistance programs for each fiscal

4 year, the President shall transmit to Congress a report

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

6 activities carried out under this paragraph for the pre7 ceding fiscal year, including a description of the extent to

8 which such programs, projects, and activities have made

9 progress to achieve the goals described in subparagraph

10 (A)(ii).’’.

11 (d) AUTHORIZATION OF APPROPRIATIONS.—Sub12 paragraph (D) of section 104(c)(7) of the Foreign Assist13 ance Act of 1961 (22 U.S.C. 2151b(c)(7)), as redesig14 nated by this Act, is amended by striking ‘‘$60,000,000

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

16 ‘‘$60,000,000 for fiscal year 2001 and $200,000,000 for

17 fiscal year 2002’’.

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