IV 
117TH CONGRESS 
2D SESSION 
H. RES. 1373 
Honoring the life of Dr. Paul Farmer by recognizing the duty of the Federal 
Government to adopt a 21st-century global health solidarity strategy 
and take actions to address past and ongoing harms that undermine 
the health and well-being of people around the world. 
IN THE HOUSE OF REPRESENTATIVES 
SEPTEMBER 20, 2022 
Ms. SCHAKOWSKY (for herself, Ms. LEE of California, Mr. RUIZ, Mr. DOG-
GETT, Ms. JACKSON LEE, Ms. JAYAPAL, Mr. KHANNA, Mr. LAWSON of 
Florida, Mr. LEVIN of Michigan, Mrs. CAROLYN B. MALONEY of New 
York, Ms. MCCOLLUM, Mr. MCGOVERN, Mr. MOULTON, Ms. NORTON, 
Ms. PORTER, Ms. PRESSLEY, Mr. SOTO, Ms. TLAIB, Mrs. WATSON 
COLEMAN, Ms. ADAMS, and Mr. BLUMENAUER) submitted the following 
resolution; which was referred to the Committee on Foreign Affairs, and 
in addition to the Committee on the Judiciary, for a period to be subse-
quently determined by the Speaker, in each case for consideration of such 
provisions as fall within the jurisdiction of the committee concerned 
RESOLUTION 
Honoring the life of Dr. Paul Farmer by recognizing the 
duty of the Federal Government to adopt a 21st-century 
global health solidarity strategy and take actions to ad-
dress past and ongoing harms that undermine the health 
and well-being of people around the world. 
Whereas Dr. Paul Farmer, who pioneered novel community- 
based strategies for the delivery of high-quality health 
care in impoverished settings, inspired a paradigmatic 
shift in global health, including inspiring robust United 
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•HRES 1373 IH 
States leadership to address the global HIV/AIDS epi-
demic in the early 2000s via the United States Presi-
dent’s Emergency Plan for AIDS Relief (PEPFAR) and 
the Global Fund to Fight AIDS, Tuberculosis, and Ma-
laria; 
Whereas in spite of this progress, weak health systems con-
tinue to cause millions of people, primarily the global 
poor, to die tragic and unnecessary deaths, including— 
(1) annually, approximately— 
(A) 680,000 deaths from HIV/AIDS; 
(B) 1,500,000 deaths from tuberculosis; 
(C) 627,000 deaths from malaria; 
(D) 295,000 deaths of mothers during and fol-
lowing pregnancy and childbirth; 
(E) 9,560,000 deaths among children under the 
age of 15; and 
(F) 560,000 deaths of children and young 
adults living among the world’s poorest billion people 
from noncommunicable diseases and injuries; and 
(2) a COVID–19 case-fatality rate up to 300 per-
cent greater in low-income countries than in high-income 
countries during the first two years of the SARS–CoV– 
2 pandemic; 
Whereas although progress against unnecessary deaths in im-
poverished countries is being made, it is occurring so 
slowly that— 
(1) based on present rates of decline, it will take ap-
proximately a century for core mortality statistics in low- 
income countries to converge with those of high-income 
countries, including— 
(A) 92 years for the tuberculosis death rate; 
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•HRES 1373 IH 
(B) 109 years for the maternal mortality rate; 
and 
(C) 88 years for the under-15 child mortality 
rate; and 
(2) the death rate in low- and middle-income coun-
tries from noncommunicable diseases and injuries, which 
make up 40 to 60 percent of the disease burden of these 
countries, will never converge with that of high-income 
countries with present rates of reduction; 
Whereas weak health systems that fail to prevent unnecessary 
deaths also lack the staff, health facility infrastructure, 
and medical technologies required for effective care deliv-
ery and thereby disease containment, thus placing all 
countries at increased risk of pandemic disease; 
Whereas essential medical technologies such as diagnostics, 
treatments, and vaccines for diseases that affect the glob-
al poor are frequently unavailable or inaccessible to 
health systems in developing countries because— 
(1) investing in research and development for tech-
nologies for diseases that disproportionately affect the 
global poor is often unprofitable for pharmaceutical cor-
porations; 
(2) high intellectual property licensing fees from 
originator companies to generic manufacturers price the 
global poor out of access to medical technologies; and 
(3) originator technology companies refuse to share 
or license intellectual property to generic manufacturers, 
which results in limited supply and high prices, as in the 
case of COVID–19 vaccines; 
Whereas the Lancet Commission on Investing in Health esti-
mates the additional annual spending required to prevent 
the vast majority of the millions of unnecessary deaths 
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•HRES 1373 IH 
and confer ‘‘essential universal health coverage’’ in low- 
and lower-middle-income countries is $75,000,000,000 
and $293,000,000,000 (in 2016 United States dollars), 
respectively, representing just— 
(1) 1.6 percent of the United States gross domestic 
product (GDP) in 2021; 
(2) 0.5 percent of G20 GDP in 2021; and 
(3) 2.8 percent of the wealth possessed by the 
world’s billionaires in 2021; 
Whereas regular annual United States appropriations for 
global health have increased by merely 10.6 percent to 
$11,300,000,000 since 2010, and have been outpaced by 
both inflation and the United States economic growth; 
Whereas relative to the size of the United States economy, 
the United States official overseas development spending 
is low at 0.17 percent of gross national income (GNI) in 
2020, placing the United States 24th out of the 29 coun-
try members of the Organization for Economic Co-oper-
ation and Development’s Development Assistance Com-
mittee, and meeting just one-fourth of the United Na-
tions official development assistance target of 0.7 percent 
GNI; 
Whereas dramatically increasing foreign aid may have voter 
support, given that opinion polls consistently find that 
Americans believe United States foreign aid should make 
up approximately 10 percent of the Federal budget; 
Whereas historically, United States and other global North- 
supported global health programs have inadvertently en-
trenched standards of care in low-income countries that 
would be unacceptable in rich countries by funding only 
health services narrowly defined as ‘‘sustainable’’, ‘‘cost- 
effective’’, or ‘‘appropriate’’ in poor settings; 
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•HRES 1373 IH 
Whereas the effectiveness and efficiency of current United 
States overseas development assistance for health is often 
undermined by— 
(1) misalignment with countries’ national health 
plans; 
(2) bypassing delivery systems with parallel inputs, 
leading to fragmentation of care delivery, poor donor co-
ordination across partners, and weak health systems; 
(3) favoring technical assistance from consultants 
from high-income countries, especially the United States, 
over funding health service delivery in beneficiary coun-
tries; and 
(4) promoting privatization of health services, there-
by undermining public system strengthening, health care 
access, health equity, and financial risk protection; 
Whereas 98 percent of the annual $1,500,000,000,000 in 
health spending in aid-eligible low- and middle-income 
countries is mobilized domestically by these countries 
themselves, and only 2 percent of this spending comes 
from overseas development assistance for health; 
Whereas many of the poorest developing countries presently 
lack the tax capacity to mobilize the necessary resources 
to close the universal health coverage financing gap, 
meaning unnecessary deaths will continue in these set-
tings for the foreseeable future without external donor fi-
nancing or dramatic increases in domestic tax capacity; 
Whereas the inability of many of the poorest developing coun-
tries to fully close the financing gap for universal health 
coverage and the provision of numerous other public 
goods and services is in part due to the intimate eco-
nomic links between these countries and high-income 
countries, including the United States, which have been 
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