The Continuing Threat of Neglected Tropical Diseases

Floor Speech

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Mr. SMITH of New Jersey. Mr. Speaker, Neglected Tropical Diseases (NTDs) are a group of 17 parasitic and bacterial diseases which blind, disable, disfigure, and sometimes kill sufferers among more than one billion of the world's poorest people, trapping the most marginalized communities in a cycle of poverty. The list ranges from chagas to rabies to leprosy to dengue fever. However, there are others not on this list of 17 diseases that also receive too little attention. These include such diseases as polio and smallpox, which have largely been eliminated from the planet, and often fatal, fortunately rare NTDs, such as kuru. Prior to last year, that list of rare diseases included Ebola.

Even though not immediately fatal, these diseases can keep children from attending school and their parents from working, as well as resulting in excessive loss of blood by mothers during birth and low birth weight babies. These conditions constitute a significant hurdle to achieving economic growth and dilute the impact of foreign assistance programs.

Last year, the world witnessed an Ebola disease pandemic that hit six African countries and spread to Spain, Scotland, and the United States. Furthermore, in recent years diseases such as dengue fever and chickugunya have spread into the United States. These and other tropical diseases most often victimize the poor who live in tropical climates--whether in Africa, Latin America or parts of the United States.

Even in the face of the worldwide challenge these tropical diseases pose, the administration has proposed cutting the budget in this area by 17%. Yesterday's hearing examined the problem of neglected tropical diseases and U.S. current and potential efforts to address this problem.

Eight NTDs account for almost all worldwide cases. Seven of them can be treated with low-cost medication that can be dispensed by non-health workers irrespective of disease status. Nearly 80% of all NTD cases are comprised of people carrying intestinal worms.

In our June 27, 2013, hearing on NTDs, we learned the catastrophic nature of these preventable intestinal worm infections. So many of the problems we struggle with, such as difficult births and malnourishment, cannot be remedied without dealing with the infections themselves. These intestinal worms not only steal nutrients from their hosts; they steal their very futures by denying them a healthy life.

We can no longer look at photos of happy young children standing in muddy water without shoes and not think of the possibility that they are losing their future even as we see them enjoy a break from the poverty in which they live. Yet we must understand that these are not merely diseases affecting people in faraway lands.

Current U.S. law favors research on those diseases threatening the American homeland, but in today's world, diseases can cross borders as easily as those affected by them or the products imported into the United States. For example, chagas is most prevalent in Latin America, but it has been identified in patients in Texas, and cases of dengue fever have recently been reported in Florida. We cannot afford to assume that what may seem to be exotic diseases only happen to people in other countries. (And of course, even if that were true, we have a moral obligation to aid and assist those who contract these diseases and mitigate transmittal to the greatest extent possible). Ten years ago, West Nile Virus, another rare disease, was not seen in the United States or anywhere else outside the east African nation of Uganda, but in less than a decade, it has spread across this country and much of the rest of the world.

More than 10,000 people have died of Ebola worldwide thus far. Although only one person died in this country due to that disease, we saw clearly how unprepared our medical services and the rest of the world were initially to deal with a rare disease that had previously been confined to isolated areas in Central Africa. There are other rare diseases--not to mention the recognized NTDs--that can cause havoc if they find their way to populated international transit areas as Ebola did last year.

Meanwhile, far too many people live lives of quiet suffering from diseases we must fight more effectively. This is why I have introduced H.R. 1797, the End Neglected Tropical Diseases Act. Among other provisions, H.R. 1797 calls on the U.S. Agency for International Development (USAID) to modify its NTD programming with respect to rapid impact package treatments, school-based NTD programs and new approaches to reach the goals of eliminating NTDs. This bill also sets forth measures to expand the USAID program, including by establishment of a research and development program.

In our effort to achieve reachable goals to prevent and eliminate NTDs, the projected 17% cut in funding for such projects in the FY 2016 budget would pose a serious setback. I have appealed to the appropriators to maintain NTD spending at the most recent regular budget levels in FY 2014, and our hearing yesterday examined how our current NTD programs will be affected either by the planned budget cut or by maintaining the level of funding we saw before the Ebola response skewed the level of such funding.

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