I 
116TH CONGRESS 
1ST SESSION H. R. 3460 
To facilitate effective research on and treatment of neglected tropical diseases 
through coordinated international efforts. 
IN THE HOUSE OF REPRESENTATIVES 
JUNE 25, 2019 
Mr. SMITH of New Jersey (for himself, Mr. MCCAUL, Ms. BASS, Mr. SHER-
MAN, Mr. MEEKS, and Mr. CICILLINE) introduced the following bill; 
which was referred to the Committee on Foreign Affairs 
A BILL 
To facilitate effective research on and treatment of neglected 
tropical diseases through coordinated international efforts. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘End Neglected Trop-
ical Diseases Act’’. 
SEC. 2. TABLE OF CONTENTS. 
Sec. 1. Short title. 
Sec. 2. Table of contents. 
Sec. 3. Statement of policy. 
Sec. 4. Findings. 
Sec. 5. Definition. 
Sec. 6. Rule of construction. 
Sec. 7. Expansion of United States Agency for International Development Ne-
glected Tropical Diseases Program. 
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Sec. 8. Actions by Department of State. 
Sec. 9. Multilateral development and health institutions. 
SEC. 3. STATEMENT OF POLICY. 
It is the policy of the United States to support a 
broad range of implementation and research and develop-
ment activities that work toward the achievement of cost- 
effective and sustainable treatment, control, and, where 
possible, elimination of neglected tropical diseases for the 
economic and social well-being of all people. 
SEC. 4. FINDINGS. 
Congress finds the following: 
(1) The World Health Organization (WHO) has 
identified 17 neglected tropical diseases (NTDs). 
Approximately 2 billion people, almost one-third of 
the world’s population, are at risk of contracting an 
NTD, and more than 1.4 billion people are currently 
afflicted with 1 or more NTDs. 
(2) In 2013, WHO adopted a comprehensive 
resolution on NTDs recognizing that increased na-
tional and international investments in prevention 
and control of neglected tropical diseases have suc-
ceeded in improving health and social well-being in 
many countries. 
(3) NTDs have an enormous impact in terms of 
disease burden and quality of life. NTDs cause the 
loss of up to 534,000 lives and 57 million disability- 
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adjusted life-years each year. NTDs surpass both 
malaria and tuberculosis in causing greater loss of 
life-years to disability and premature death. Many 
NTDs cause disfigurement and disability, leading to 
stigma, 
social 
discrimination, 
and 
societal 
marginalization. 
(4) NTDs create an economic burden of billions 
of dollars through the loss of productivity and high 
costs of health care required for treatment. People 
afflicted by NTDs are less productive than their 
healthy counterparts. NTDs jeopardize the ability of 
people to attend work and school, or to produce at 
full capacity. For example, controlling one NTD, 
hookworm, in children can result in a 43-percent in-
crease in future wage earnings. 
(5) The social, economic, and health burden of 
NTDs falls primarily on low- and middle-income 
countries, where access to safe water, sanitation, 
and health care is limited. At least 100 countries 
face 2 endemic NTD burdens, and 30 countries 
carry 6 or more endemic NTDs. 
(6) NTDs are not confined to the developing 
world, however. Several NTD outbreaks have been 
reported in the United States and other developed 
countries, especially among the poor. In the United 
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States, NTDs disproportionately affect people living 
in poverty, and especially minorities, including up to 
2.8 million African Americans with toxocariasis and 
300,000 or more people, mostly Hispanic Americans, 
with Chagas disease. 
(7) Many NTDs can be controlled, prevented, 
and even eliminated using low-cost, effective, and 
feasible solutions. Understanding the economic bur-
den of NTDs on productivity and health care costs 
can help to assure governments and donors that the 
resources directed toward NTDs represent a good 
investment. 
(8) Research and development efforts are imme-
diately needed for all NTDs, especially those for 
which limited or no treatment currently exists. 
(9) Critical to developing robust NTD control 
strategies are epidemiological data that identify at- 
risk populations, ensure appropriate treatment fre-
quency, and inform decisions about when treatment 
can be reduced or stopped. 
(10) Of the 14 most common NTDs, roughly 
80 percent of infections are caused by soil-trans-
mitted helminths (STH) and schistosomiasis. STH 
are a group of 3 parasitic worms (roundworms, 
whipworms, and hookworms) that afflict more than 
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1 billion people worldwide, including 600 million 
school-age children, of whom more than 300 million 
suffer from severe morbidity. Schistosomiasis is an-
other helminth infection affecting at least 200 mil-
lion people in developing countries, but some esti-
mates indicate that the true number of people af-
fected may be double or even triple that number. 
(11) The benefits of deworming are immediate 
and enduring. A rigorous randomized controlled trial 
has shown school-based deworming treatment to re-
duce school absenteeism by 25 percent. School-based 
deworming also benefits young siblings and other 
children who live nearby but are too young to be 
treated, leading to large cognitive improvements 
equivalent to half a year of schooling. 
SEC. 5. DEFINITION. 
In this Act, the term ‘‘neglected tropical diseases’’ or 
‘‘NTDs’’— 
(1) means infections caused by pathogens, in-
cluding viruses, bacteria, protozoa, and helminths 
that disproportionately impact individuals living in 
extreme poverty, especially in developing countries; 
and 
(2) includes— 
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(A) Buruli ulcer (Mycobacterium Ulcerans 
infection); 
(B) Chagas disease; 
(C) dengue or severe dengue fever; 
(D) dracunculiasis (Guinea worm disease); 
(E) echinococcosis; 
(F) foodborne trematodiases; 
(G) human African trypanosomiasis (sleep-
ing sickness); 
(H) leishmaniasis; 
(I) leprosy; 
(J) lymphatic filariasis (elephantiasis); 
(K) onchocerciasis (river blindness); 
(L) scabies; 
(M) schistosomiasis; 
(N) soil-transmitted helminthiases (STH) 
(roundworm, whipworm, and hookworm); 
(O) taeniasis/cysticercosis; 
(P) trachoma; and 
(Q) yaws (endemic treponematoses). 
SEC. 6. RULE OF CONSTRUCTION. 
Nothing in this Act shall be construed to increase au-
thorizations of appropriations for the United States Agen-
cy for International Development. 
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SEC. 7. EXPANSION OF UNITED STATES AGENCY FOR 
INTERNATIONAL DEVELOPMENT NEGLECTED 
TROPICAL DISEASES PROGRAM. 
(a) FINDINGS.—Congress finds the following: 
(1) Since fiscal year 2006, the United States 
Government has been an essential leader in global 
efforts to control seven targeted neglected tropical 
diseases: 
lymphatic 
filariasis 
(elephantiasis), 
onchocerciasis (river blindness), schistosomiasis, soil- 
transmitted helminthiases (roundworm, whipworm, 
and hookworm), and trachoma. Additional informa-
tion suggests that such efforts could also produce 
collateral benefits for at least three other neglected 
tropical diseases: foodborne trematodiases, scabies, 
and yaws (endemic treponematoses). 
(2) The United States Government is a partner 
in the London Declaration on Neglected Tropical 
Diseases (2012), which represents a new, coordi-
nated international push to accelerate progress to-
ward eliminating or controlling 10 NTDs by 2020. 
(3) While many of the most common NTDs 
have safe, easy to use, and effective treatments, 
treatment options for the NTDs with the highest 
death 
rates, 
including 
human 
African 
trypanosomiasis (sleeping sickness), visceral leishma-
niasis, and Chagas disease, are extremely limited. 
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(4) The United States Agency for International 
Development (USAID) Neglected Tropical Diseases 
Program has made important and substantial con-
tributions to the global fight to control and eliminate 
5 of the most common NTDs. Leveraging more than 
$15,700,000,000 in donated medicines, USAID has 
supported the distribution of more than 1 billion 
treatments in 31 countries across Africa, Asia, and 
Latin America and the Caribbean. 
(5) Since 2014, the USAID Neglected Tropical 
Diseases Program has been investing in research 
and development for the treatment of certain NTDs 
to ensure that promising new breakthrough medi-
cines can be rapidly evaluated, registered, and made 
available to patients. 
(6) The USAID Neglected Tropical Diseases 
Program is a clear example of a successful public- 
private partnership between the Government and the 
private sector and should be judiciously expanded, as 
practicable and appropriate. 
(b) SENSE OF CONGRESS.—It is the sense of Con-
gress that the USAID Neglected Tropical Diseases Pro-
gram, as in effect on the date of the enactment of this 
Act, should— 
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