Testimony of Rep. Eliot Engel
TB Hearing
Subcommittee on Africa and Global Health
March 21, 2007
Chairman Payne and Ranking member Smith, I wish to thank you for holding this important hearing today and for providing me with the opportunity to testify before you in support of international tuberculosis control and treatment efforts. I am grateful for this opportunity and for your strong commitment to this important issue.
Failing to improve our International TB control efforts will wield a devastating blow to our ability to manage what I believe is a mounting global health crisis. It is remarkable in this day and age, with treatment available, that TB is the biggest infectious killer of young women in the world. In fact, TB kills more women worldwide than all causes of maternal mortality. As you know, TB is also the biggest killer of people with AIDS worldwide. Someone in the world is newly infected with TB every second, and TB accounts for more than one quarter of all preventable adult deaths in developing countries. The statistics are simply staggering.
I strongly believe that the global community, with the U.S. in the lead, must do more to adequately address this disease by investing in quality TB control programs, using the groundbreaking Global Plan to Stop TB as a guide. It is for that reason that I have introduced the bi-partisan Stop TB Now Act of 2007 with my colleagues Heather Wilson and Adam Smith which will set forth what we believe is the U.S. fair share towards achieving the goals of the Global Plan. The Stop TB Now Act will strengthen US leadership on international TB control by providing increased resources for the development of urgently needed new TB diagnostic and treatment tools to USAID and CDC. My bill calls for a U.S. investment of $400 million for international TB control in FY08 and $550 million in FY09.
Chairman Payne, we wish to thank you for your co-sponsorship of this important measure. I also would like to thank the many global health groups that we have worked with on this legislation, who have also endorsed H.R. 1567: the RESULTS Educational fund,
The American Thoracic Society and the Global Health Council.
If we don't make bold - and wise - investments in international TB control, not only will we fail to save millions of lives and miss out on the many accompanying benefits of controlling this killer, but this disease will also become far more difficult and costly to treat.
Extremely Drug Resistant TB or "XDR-TB" for short highlights this danger. It has been found on six continents, is a growing epidemic in southern Africa, and is already reported to be here in the United States. Regular (non drug-resistant) TB is curable with drugs that cost just $16 dollars in most developing countries. Cases of drug-resistant TB, however, can cost thousands of dollars to cure, with treatment that is far more difficult for patients and practitioners. Drug-resistant TB is a man-made problem and is caused by an array of factors including the misuse of anti-biotics, inadequate funding for laboratory testing and inadequate access to needed drugs. We (the global community) have the power to prevent drug-resistant TB and the power to treat and control regular TB, and yet we have not chosen to do so on the scale that is necessary.
I know that you decided to hold this hearing because you wanted to highlight the fact that in Africa, the intersection between TB and HIV/AIDS is particularly chilling. People with HIV/AIDS have compromised immune systems, and therefore, TB and drug-resistant TB hit them especially hard. In 2004, more than 740,000 people who contracted TB were co-infected with HIV/AIDS. Globally, 90% of people living with AIDS die within 4 to 12 months of contracting TB if not treated.
We must all be concerned that with drug-resistant TB spiraling out of control, especially in HIV/AIDS patients in Africa, the reductions in mortality rates from HIV/AIDS thanks to Anti-Retroviral treatment are now in severe jeopardy. If we do not take urgent action now, progress made on the front lines of the fight against HIV/AIDS is in very serious danger of being undermined by drug-resistant TB. As Nelson Mandela said in 2004, "We cannot win the battle against AIDS if we do not also fight TB."
The Stop TB Partnership's Global Plan to Stop TB projects that Africa will require $19.4 billion to strengthen and maintain country-level TB control efforts through 2015. This represents nearly 44 percent of the global total needed for countries to find and properly treat people with TB. While significant resources are being provided and will be provided by African governments themselves, the remaining funding gap for Africa stands at $11 billion over the next decade - with additional resources needed to scale up a response to drug-resistant TB. XDR-TB is a wake-up call for the longstanding need to strengthen TB control and to build the necessary capacity in health services to respond to drug-resistant TB.
Again, my bill, the Stop TB Now Act of 2007, seeks to authorize the funding level required from the U.S. in order to meet the goals of the Global Plan to Stop TB and therefore be able to address this TB problem globally. I urge the Subcommittee members in attendance today to cosponsor my bill and I respectfully ask Chairman Payne and Ranking member Smith to bring this bill up for consideration in this subcommittee.
Thank you again for allowing me to testify before you today and for holding this important hearing. As advocates across the globe come together on March 24 in recognition of World TB Day, your efforts today to further the dialogue on TB control efforts with testimony by experts from the Centers for Disease Control, Office of the Global AIDS Coordinator, United States Agency for International Development, World Health Organization and Partners in Health will certainly not go unnoticed. We will all benefit from the information gathered today.
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