[House Hearing, 115 Congress] [From the U.S. Government Publishing Office] END NEGLECTED TROPICAL DISEASES ACT ======================================================================= MARKUP BEFORE THE SUBCOMMITTEE ON AFRICA, GLOBAL HEALTH, GLOBAL HUMAN RIGHTS, AND INTERNATIONAL ORGANIZATIONS OF THE COMMITTEE ON FOREIGN AFFAIRS HOUSE OF REPRESENTATIVES ONE HUNDRED FIFTEENTH CONGRESS FIRST SESSION ON H.R. 1415 __________ JUNE 15, 2017 __________ Serial No. 115-37 __________ Printed for the use of the Committee on Foreign Affairs [GRAPHIC NOT AVAILABLE IN TIFF FORMAT] Available via the World Wide Web: http://www.foreignaffairs.house.gov/ or http://www.gpo.gov/fdsys/ ______ U.S. GOVERNMENT PUBLISHING OFFICE 25-842 PDF WASHINGTON : 2017 ---------------------------------------------------------------------------------------- For sale by the Superintendent of Documents, U.S. Government Publishing Office, http://bookstore.gpo.gov. For more information, contact the GPO Customer Contact Center, U.S. Government Publishing Office. Phone 202-512-1800, or 866-512-1800 (toll-free). E-mail, [email protected]. COMMITTEE ON FOREIGN AFFAIRS EDWARD R. ROYCE, California, Chairman CHRISTOPHER H. SMITH, New Jersey ELIOT L. ENGEL, New York ILEANA ROS-LEHTINEN, Florida BRAD SHERMAN, California DANA ROHRABACHER, California GREGORY W. MEEKS, New York STEVE CHABOT, Ohio ALBIO SIRES, New Jersey JOE WILSON, South Carolina GERALD E. CONNOLLY, Virginia MICHAEL T. McCAUL, Texas THEODORE E. DEUTCH, Florida TED POE, Texas KAREN BASS, California DARRELL E. ISSA, California WILLIAM R. KEATING, Massachusetts TOM MARINO, Pennsylvania DAVID N. CICILLINE, Rhode Island JEFF DUNCAN, South Carolina AMI BERA, California MO BROOKS, Alabama LOIS FRANKEL, Florida PAUL COOK, California TULSI GABBARD, Hawaii SCOTT PERRY, Pennsylvania JOAQUIN CASTRO, Texas RON DeSANTIS, Florida ROBIN L. KELLY, Illinois MARK MEADOWS, North Carolina BRENDAN F. BOYLE, Pennsylvania TED S. YOHO, Florida DINA TITUS, Nevada ADAM KINZINGER, Illinois NORMA J. TORRES, California LEE M. ZELDIN, New York BRADLEY SCOTT SCHNEIDER, Illinois DANIEL M. DONOVAN, Jr., New York THOMAS R. SUOZZI, New York F. JAMES SENSENBRENNER, Jr., ADRIANO ESPAILLAT, New York Wisconsin TED LIEU, California ANN WAGNER, Missouri BRIAN J. MAST, Florida FRANCIS ROONEY, Florida BRIAN K. FITZPATRICK, Pennsylvania THOMAS A. GARRETT, Jr., Virginia Amy Porter, Chief of Staff Thomas Sheehy, Staff Director Jason Steinbaum, Democratic Staff Director ------ Subcommittee on Africa, Global Health, Global Human Rights, and International Organizations CHRISTOPHER H. SMITH, New Jersey, Chairman MARK MEADOWS, North Carolina KAREN BASS, California DANIEL M. DONOVAN, Jr., New York AMI BERA, California F. JAMES SENSENBRENNER, Jr., JOAQUIN CASTRO, Texas Wisconsin THOMAS R. SUOZZI, New York THOMAS A. GARRETT, Jr., Virginia C O N T E N T S ---------- Page MARKUP ON H.R. 1415, End Neglected Tropical Diseases Act................... 2 APPENDIX Markup notice.................................................... 22 Markup minutes................................................... 23 Markup summary................................................... 24 END NEGLECTED TROPICAL DISEASES ACT ---------- THURSDAY, JUNE 15 , 2017 House of Representatives, Subcommittee on Africa, Global Health, Global Human Rights, and International Organizations, Committee on Foreign Affairs, Washington, DC. The subcommittee met, pursuant to notice, at 11:30 a.m., in room 2255 Rayburn House Office Building, Hon. Christopher H. Smith (chairman of the subcommittee) presiding. Mr. Smith. The subcommittee will come to order and good morning to everyone. Pursuant to notice, we are here this morning to work up Title I of H.R. 1415, the End Tropical Diseases Act. [The information referred to follows:] [GRAPHICS NOT AVAILABLE IN TIFF FORMAT Mr. Smith. Title I is in jurisdiction of the Committee on Foreign Affairs; whereas, Title II is in the Energy and Commerce Committee, so that will have to be done by them and we are pushing hard for that to happen. I know that the measure is unopposed and no amendments have been put forward. I also note that the subcommittee will reconvene following this markup for a hearing. With other events that have been scheduled and upon consultation with Ranking Member Bass and pursuant to yesterday's notice, we intend to consider this bill in an expedited manner. All members have a copy of H.R. 1415 before them. After we have concluded our expedited consideration, I would be glad to recognize any member, including myself and the ranking member, or Dr. Bera, since he is serving in that position right now, for any statements they might have on the issue. All members are given leave to assert written remarks into the record, if they so choose. Seeing again that we have a reporting quorum present, without objection, H.R. 1415, the End Tropical Diseases Act, Title I only, is considered as read. The Chair moves that it be adopted. All those in favor, say aye. All those opposed, say no. The ayes have it, in the opinion of the Chair. The item is adopted. Without objection, the measure is reported favorably to the full committee and the staff is directed to make any technical and conforming changes. I will just say a few opening comments on this legislation. Neglected tropical diseases--and let me just say, too, this is the second Congress that we were trying to get this legislation passed. We got it out of our full committee last year. Regrettably, it stalled in the Energy and Commerce Committee but my hope is that that will not be the case this year. Neglected tropical diseases are a group of 17 parasitic and bacterial diseases which blind, disable, disfigure, and sometimes kill victims from among the more than 1 billion of the world's poorest people, trapping the most marginalized communities into a cycle of poverty. These diseases can keep children from attending school and their parents from working, and cause excessive bleeding by mothers during birth and results often in low birth weight babies. NTDs, therefore, constitute a significant hurdle to achieving economic growth and dilute the impact of foreign assistance programs. While tropical diseases primarily affect communities in developing countries, outbreaks have been reported in the United States and developing countries in recent years, such as the West Nile virus, Dengue fever, and most recently Zika. The most common NTDs can be controlled and eliminated; however, there is still much work to be done to prepare for currently unknown diseases that may appear on the international scene and to reach the World Health Organization's control and elimination goals by 2020. To achieve these goals, heightened support is needed now from both new and longstanding partners. H.R. 1415 supports the control and elimination of NTDs in the United States by, among other things, supporting USAID's NTD program to better integrate NTD control and elimination efforts with other development issues such as HIV/AIDS, malaria, water and sanitation, and education; conduct research and development for improved drugs, diagnostics, and vaccines to control or to eliminate NTDs; directing the U.S. Government to advocate for increased efforts to address NTDs among international institutions, such as the U.N., WHO, and the World Bank; calling for the Department of Health and Human Services to submit a report on NTDs in the U.S. to better understand the epidemiology, impact, and appropriate funding needed to address NTDs domestically; encouraging the creation of one or more NTD Centers of Excellence. I would note parenthetically that in the year 2000, I authored legislation on the issue of autism and the mainstay of the legislation was a series of those Centers of Excellence. And those Centers of Excellence and the work that now CDC and NIH do on autism has resulted in a major push to try to help those with autism, discover root causes, and to promote early childhood intervention and it came out of those Centers of Excellence. So this could be a game changer, we think, in a game that has to be changed for the sake of the poor and marginalized communities. It also would establish a panel on intestinal worm infections to evaluate and make recommendations regarding potential solutions to worm infections, which impact more than 1 billion people worldwide, including 600 million school-aged children. Secretary of State Rex Tillerson told the Foreign Affairs Committee, full committee, yesterday that the administration was committed to remaining a leader in areas including global health. They can demonstrate that commitment by continuing to support the work done by CDC and the National Institutes of Health, and the U.S. Agency for International Development. And I do believe that as we move forward on this budget, those gaping cuts will not materialize. And I know I and others will work hard to ensure that we do more, in some cases, rather than less. It is long past time for Congress to affirm this work, particularly in the area of NTDs. And I want to thank Ranking Member Bass, Congressmen Dan Donovan, Gregory Meeks, Sanford Bishop, and Eleanor Holmes Norton for joining us as early cosponsors of this legislation. And I would like to yield to Dr. Bera, if he has any comments he would like to make. Mr. Bera. Great. Thank you, Mr. Chairman. I will keep my comments brief but I think this is an important piece of legislation. I look at this as a physician who has worked overseas. And you know we don't always think about neglected tropical diseases. The folks sitting around the table at home may not be talking about schistosomiasis or trachoma but the truth is, these are diseases that affect millions around the world. And the reason why investing in this research and looking for cures are so important, it is a reflection of not only our values, as a nation, to engage with our allies and other like-valued countries around the world to relieve suffering, we also know that the world is much more interconnected today. You know diseases that emerge much like Ebola a few years ago or Zika in one part of the world certainly move and spread. So, we can't just think about how we address health and disease here in the United States. We have also got to go where those diseases are and look for those discoveries. So you know it is my hope that this moves quickly through the full committee and to the floor of the House. And, again, it is a reflection of who we are as a nation, our values to be concerned and focus on that suffering around the world. So, thank you, Mr. Chairman. I will yield back. Mr. Smith. Thank you, Dr. Bera. Mr. Donovan. Mr. Donovan. Thank you, Mr. Chairman. I just want to take a moment to thank you for your leadership in this area. I mean global health has become a great interest of mine since I got here 2 years ago. We deal daily with the preventable diseases throughout the world. As Dr. Bera says, we are a compassionate, leading Nation. We outsource our abilities to help others. As he also mentioned, because of the ability for people to travel, many diseases that may not affect our Nation now because people traveling to our country affect us as well but, through our compassion and leadership, this Nation should do everything it can to relieve other countries of diseases that are preventable and nonexistent in our own country. You have been a leader in this area for so many, many years, I just wanted to thank you, Mr. Chairman, and I thank my colleague for supporting this legislation. Mr. Smith. Thank you very much. Mr. Suozzi. Mr. Suozzi. I will associate my remarks with everything that has been said already and thank you for your leadership. Thank you. Mr. Smith. Well, thank you. Mr. Garrett. Mr. Garrett. Thank you, Mr. Chairman. Very briefly, I think budget hawks might look at this and wonder what the purview was of this organization as it relates to this action. I would answer them by saying it is difficult, if not impossible, to separate global health from American health; that in a world with intercontinental travel, in a world that shrinks by the day conceptually, the idea to combat these NTDs abroad, rather than at home, might parallel the hawkish line that some take on the War on Terror. I would associate myself with the gamut of individuals on this committee and submit that, while it is not just being a good neighbor, it is also being a good tenant in our home and this is good policy at every level. Thank you. Mr. Smith. Mr. Garrett, thank you so very much. Thanks to all the members of the subcommittee for their support and their excellent remarks. Without further ado, the markup is concluded. [Whereupon, at 11:53 a.m., the subcommittee was adjourned.] A P P E N D I X ---------- [GRAPHICS NOT AVAILABLE IN TIFF FORMAT [all]