countries, it was contained and controlled by the 
well-equipped health systems in those areas. 
(8) 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. 
(9) Research and development efforts are imme-
diately needed for all NTDs, especially those for 
which limited or no treatment currently exists. 
(10) 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. 
(11) 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 three parasitic worms (roundworms, 
whipworms, and hookworms) that afflict more than 
one billion people worldwide, including 600 million 
school-age children, of whom more than 300 million 
suffer from severe morbidity. Schistosomiasis is an-
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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. 
(12) The main health problems caused by STH 
are related to their negative effect on childhood nu-
tritional status, which can cause stunting and wast-
ing. For example, STH infection may lead to ane-
mia, malabsorption of nutrients, loss of appetite, 
nausea, abdominal pain, diarrhea, and reduced food 
intake. When such health problems are experienced 
in early childhood, a peak growth and development 
period, the mental and physical damage—and loss of 
future productivity and wage-earning potential—will 
likely be irreversible. Schistosomiasis causes end- 
organ damage to the urinary tract, female genital 
tract, liver and intestines. It also results in chronic 
health conditions in children. 
(13) STH and schistosomiasis are also particu-
larly detrimental to the health of women of repro-
ductive age and pregnant women. Their underlying 
poor iron status makes these women most suscep-
tible to developing anemia. Iron deficiency anemia 
resulting from hookworm infection during pregnancy 
has been linked to poor pregnancy outcomes such as 
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prematurity, low birth weight, and impaired lacta-
tion. Female genital schistosmiasis may be one of 
the most common gynecologic conditions in Africa 
leading to genital pain, itching, and bleeding and 
markedly increased susceptibility to HIV/AIDS. 
(14) Fortunately, there is a simple, cost-effec-
tive solution to STH and schistosomiasis infections: 
single-dose deworming pills that can be safely ad-
ministered once or twice annually to those at risk. 
Pharmaceutical companies have committed to donate 
the drugs needed to treat all at-risk, school-age chil-
dren in developing countries. Regular administration 
of deworming pills reduces morbidity associated with 
STH and schistosomiasis infections by reducing 
prevalence and transmission rates. 
(15) Improved access to water, sanitation, and 
hygiene (WASH) can also reduce the transmission of 
NTDs, particularly intestinal worms. 
(16) 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 
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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— 
(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) rabies; 
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(M) schistosomiasis; 
(N) soil-transmitted helminthiases (STH) 
(round worm, whip worm, and hook worm); 
(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 or authorizations of ap-
propriations for the Department of Health and Human 
Services. 
TITLE I—FOREIGN AFFAIRS 
SEC. 101. EXPANSION OF USAID NTDS PROGRAM. 
(a) FINDINGS.—Congress finds the following: 
(1) Since fiscal year 2006, the United States 
Government has been an essential leading partner in 
advancing control and elimination efforts for seven 
targeted neglected tropical diseases: lymphatic fila-
riasis (elephantiasis), onchocerciasis (river blind-
ness), schistosomiasis, soil-transmitted helminthiases 
(STH) (round worm, whip worm, and hook worm), 
and trachoma. Additional information suggests that 
such efforts could also produce collateral benefits for 
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