Bills
| 3.23.22

Should Programs to Address Neglected Tropical Diseases Be Expanded? (H.R. 3460)

Do you support or oppose this bill?

What is H.R. 3460?

(Updated May 29, 2020)

This bill — the End Neglected Tropical Diseases Act — would expand programs to address neglected tropical diseases (NTDs), which are infections caused by pathogens, including viruses, microbes, and helminths (parasitic worms), that disproportionately impact individuals living in extreme poverty, especially in developing countries. These diseases include leprosy, lymphatic filariasis (elephantiasis), and scabies.

The NTDs Program of the U.S. Agency for International Development (USAID) would be directed to incorporate specified priorities, including: 1) conducting monitoring and evaluation of program investments; 2) including morbidity management in treatment plans; 3) addressing additional NTDs recognized as high-burden diseases; 4) continuing investments in research and development; and 5) investing in education (including primary and pre-primary education), food and nutrition security, maternal and child access to healthcare and water, sanitation and hygiene.

The president would be required to direct the U.S. Executive Director at the International Bank for Reconstruction and Development to urge the World Bank Institute to take actions on NTDs, including deworming programs.

The Dept. of Health and Human Services (HHS) would be required to: 1) continue to promote the need for NTDs programs and activities through interagency groups and international forums; 2) report to Congress on NTDs in the United States; and 3) establish a panel to evaluate issues relating to worm infections, including potential solutions such as deworming medicines. The worm infections panel would also be responsible for developing five strategies for preventing recurrent infections, providing sanitation solutions, developing safer, better medicines and improving the cost-efficiency of the existing programs regarding worm infections. 

The bill would authorize the Centers for Disease Control and Prevention (CDC) to enter into agreements and make grants to support one or more centers of excellence for NTD research, training, and treatment. These centers would be charged with conducting research into, training in and development of diagnosis, prevention, control and treatment methods for neglected tropical diseases.

This bill also addresses the need for the Global Fund — a public-private entity that focuses on assisting people with AIDs, tuberculosis, and malaria — to start recognizing and working with NTDs. It urges the Global Fund to focus on female genital schistosomiasis (FGS, a manifestation of Schistosoma haematobium infection) in addition to providing treatment for HIV/AIDS.

Argument in favor

Neglected tropical diseases (NTDs) affect nearly one-third of the global population. These diseases negatively impact families’ economic stability, affect children’s ability to attend school, and hamper countries’ economic growth. They trap communities in a cycle of poverty and can contribute to global conflicts that affect everyone.

Argument opposed

The U.S. has already significantly increased its attention to NTDs over the past decade through increased spending and charging a number of government agencies with addressing this challenge. It has already made addressing NTDs part of U.S. foreign policy and made funding available for this effort, there’s no need for this legislation.

Impact

Neglected tropical diseases (NTDs); international health; international affairs; and U.S. commitment to addressing NTDs.

Cost of H.R. 3460

The CBO estimates that this bill wouldn’t affect the budgets of USAID or the State Dept., and therefore wouldn’t have any cost to implement.

Additional Info

In-Depth: Sponsoring Rep. Chris Smith (R-NJ) reintroduced this bill from the 115th Congress to address neglected tropical diseases. When this bill passed the House Foreign Affairs Committee in the 115th Congress, Rep. Smith said: 

“[This bill] deals with a group of seventeen parasitic, bacterial, and viral diseases which blind, disable, disfigure, and sometimes kill victims from among the more than one billion of the world’s poorest people. These diseases trap the most marginalized communities in a cycle of poverty. [This bill] will support the control and elimination of NTDs [natural tropical diseases] in the U.S. and abroad. This legislation emphasizes field research by USAID on the impact of treatments that helps future application of often lifesaving medicines. These diseases not only can keep children from attending school and their parents from working, they also cause excessive bleeding by mothers during birth and result in low birth weight babies. The most common NTDs can be controlled and eliminated with the application of low-cost donated medicines. 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.”

The Borgen Project supports this bill. Its writer, Graham Gordon, says: 

“According to the World Health Organization (WHO), almost one-third of the world’s population is at risk of being affected by a neglected tropical disease (NTD). More than one billion people are currently afflicted. The vast majority of these people live in developing countries where treatment is unavailable or too expensive to be feasible. However, many of these diseases are easily treatable in already developed nations. The End Neglected Tropical Diseases Act aims to extend these cures and preventative measures to those who have not yet had access to them in an accessible and affordable manner… While NTDs are primarily located in developing countries, their impacts are felt domestically as well. In the U.S., the poor, or more specifically poor minorities,  are susceptible to contracting these tropical diseases. Currently, 2.8 million African Americans are affected by toxocariasis. At least 300,000 people, mainly Latin American immigrants, are affected by Chagas disease. Besides the direct impact on U.S. soil, it has been shown time and time again that reducing poverty globally directly helps the U.S. economy. By creating conditions that are right for development in developing countries, we can help the poor become consumers. When the world has more consumers, it creates a larger need for jobs in the U.S. to create goods and diversify marketing strategies.”

The Sabin Vaccine Institute supported this bill in the 113th Congress. Its president, Dr. Peter Hotez, said: 

“This bill offers real promise for the more than one billion impoverished people worldwide – including U.S. citizens – currently suffering unnecessarily from NTDs. Even with medicines already available to protect against the most common NTDs, and groundbreaking R&D initiatives underway, greater prioritization for treatment delivery, scientific discovery and other cost-effective investments are necessary to defeat these devastating diseases once and for all. I applaud Congressman Chris Smith’s leadership in raising the profile of NTDs, spotlighting neglected populations and championing the necessary actions to close the remaining gaps through this legislation. I urge other Congressional leaders, global policymakers and private partners to offer their support for this historic effort by joining the fight against some of today’s most pernicious diseases.”

This legislation passed the House Foreign Affairs Committee by voice vote with the support of six bipartisan House cosponsors, including five Democrats and one Republican. Its Senate companion, sponsored by Sen. Sherrod Brown (D-OH), has one Senate cosponsor, Sen. Roger Wicker (R-MS).

Last Congress, this bill passed the House Foreign Affairs Committee by voice vote with the support of 10 bipartisan House cosponsors, including eight Democrats and two Republicans. Its Senate version, sponsored by Sen. Sherrod Brown (D-OH), had two bipartisan Senate cosponsors, including one Democrat and one Republican, and didn’t receive a committee vote.


Of Note: Neglected tropical diseases (NTDs) are diseases that disproportionately affect those living in extreme poverty, especially in tropical, developing areas such as Central America, South America, Central Africa, and Southeast Asia. The “neglected” part of the term refers to how these diseases are often hidden in remote, impoverished areas where people have no voice. There are currently 17 officially identified NTDs, of which the five most common are: intestinal worms from helminth infections, Schistosomiasis, Lymphatic Filariasis, Onchocerciasis, river blindness, and Trachoma.

The World Health Organization (WHO) says that nearly one-third of the world’s population is at risk of being affected by an NTD. Each year, NTDs cause the loss of about 57 million years of accumulated life as a direct result of their symptoms. They also kill over 534,000 people a year, and can result in social ostracization and mental distress (which can be even worse for women and girls). 

NTDs can also cause afflicted children to miss out on education due to the direct effects of the illnesses and fear of spreading the diseases. This affects children’s future success in life and countries’ economies.

Because NTDs can lead to high medical costs from hospital stays and ongoing treatment, their economic burdens can severely impact communities, contributing to lack of productivity and heightened healthcare costs. At an individual level, NTD sufferers experience fatigue that may make it difficult for them to hold a job, get an education, and contribute to their communities.

The Kaiser Family Foundation (KFF) notes that U.S. attention to and funding for NTDs have both increased “markedly” over the past 10 years. It notes, “Historically, the U.S. government’s response to NTDs was relatively limited, focusing largely on research and surveillance conducted by the National Institutes of Health (NIH), the Centers for Disease Control and Prevention (CDC), and the Department of Defense (DoD). In 2006, Congress first appropriated funds to the U.S. Agency for International Development (USAID) for integrated NTD control, after which the agency launched its NTD Program. In 2008, the USG announced expanded NTD efforts, building on USAID’s NTD Program. In 2012, the U.S. signed onto the London Declaration, and more recently, the U.S. adopted a longer term global health goal of protecting communities from infectious diseases and highlighted the important role of NTD efforts in achieving this goal.”


Media:

Summary by Lorelei Yang

(Photo Credit: iStockphoto.com / Avatar_023)