II 

116TH CONGRESS 

1ST SESSION S. 834 

To amend the Public Health Service Act to enhance the national strategy 

for combating and eliminating tuberculosis, and for other purposes. 

IN THE SENATE OF THE UNITED STATES 

MARCH 14, 2019 

Mr. BROWN introduced the following bill; which was read twice and referred 

to the Committee on Health, Education, Labor, and Pensions 

A BILL 

To amend the Public Health Service Act to enhance the 

national strategy for combating and eliminating tuberculosis, and for other purposes. 

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled, 

3 SECTION 1. SHORT TITLE. 

4 This Act may be cited as the ‘‘Comprehensive TB 

5 Elimination Act of 2019’’. 

6 SEC. 2. NATIONAL STRATEGY FOR COMBATING AND ELIMI7 NATING TUBERCULOSIS. 

8 (a) IN GENERAL.—Section 317E of the Public 

9 Health Service Act (42 U.S.C. 247b–6) is amended— 

10 (1) in subsection (a)— 


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1 (A) by striking ‘‘The Secretary’’ and in2 serting the following: 

3 ‘‘(1) GRANTS.—The Secretary’’; and 

4 (B) by adding at the end the following: 

5 ‘‘(2) PRIORITY.—In making grants under this 

6 subsection, the Secretary may give priority to award7 ing grants to State health departments proposing to 

8 focus on the prevention, control, and elimination of 

9 tuberculosis in high-risk populations, including for10 eign-born, homeless, incarcerated, HIV-tuberculosis 

11 coinfected, and medically underserved populations.’’; 

12 (2) in subsection (b)— 

13 (A) in paragraph (3)— 

14 (i) in subparagraph (C), by redesig15 nating clauses (i) and (ii) as subclauses (I) 

16 and (II), respectively, and adjusting the 

17 margins accordingly; and 

18 (ii) by redesignating subparagraphs 

19 (A) through (F) as clauses (i) through (vi), 

20 respectively, and adjusting the margins ac21 cordingly; 

22 (B) by redesignating paragraphs (1) 

23 through (8) as subparagraphs (A) through (H), 

24 respectively, and adjusting the margins accord25 ingly; 


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1 (C) in the matter preceding subparagraph 

2 (A), as so redesignated, by striking ‘‘With re3 spect to’’ and inserting the following: 

4 ‘‘(1) IN GENERAL.—With respect to’’; 

5 (D) by striking subparagraph (B), as so 

6 redesignated, and inserting the following: 

7 ‘‘(B) Research, investigations, experiments, 

8 demonstrations, and studies in the health 

9 sciences that are related to— 

10 ‘‘(i) the development of new tools, in11 cluding vaccines and antimicrobial drugs, 

12 to prevent and treat tuberculosis; 

13 ‘‘(ii) novel therapeutics for special 

14 populations, including pediatric popu15 lations, immunosuppressed individuals, and 

16 pregnant women; 

17 ‘‘(iii) the development or testing of 

18 medical diagnostics to detect tuberculosis; 

19 ‘‘(iv) research to address the epidemi20 ology, mechanisms, and pathogenesis of tu21 berculosis; 

22 ‘‘(v) public health interventions to ad23 dress the prevention, treatment, and con24 trol of tuberculosis, such as directly obVerDate Sep 11 2014 00:22 Mar 29, 2019 Jkt 089200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\S834.IS S834

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1 served therapy and non-pharmaceutical 

2 intervention; 

3 ‘‘(vi) methods to enhance detection 

4 and response to outbreaks of tuberculosis, 

5 including multidrug resistant tuberculosis; 

6 and 

7 ‘‘(vii) other relevant research areas.’’; 

8 (E) in subparagraph (C), as so redesig9 nated— 

10 (i) by redesignating clause (vi), as so 

11 redesignated, as clause (vii); 

12 (ii) in clause (v), as so redesignated, 

13 by striking ‘‘; and’’ and inserting ‘‘;’’; and 

14 (iii) by inserting after clause (v), as so 

15 redesignated, the following: 

16 ‘‘(vi) the intensification of efforts to 

17 prevent, detect, and treat latent tuber18 culosis; and’’; 

19 (F) in subparagraph (D), as so redesig20 nated, by inserting before the period the fol21 lowing: ‘‘, including public awareness campaigns 

22 and development of educational, risk, and 

23 media communications.’’; 

24 (G) in subparagraph (F), as so redesig25 nated, by striking ‘‘paragraphs (1) through 


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1 (4)’’ and inserting ‘‘subparagraphs (A) through 

2 (D)’’; and 

3 (H) by adding at the end the following: 

4 ‘‘(2) SELECTION.—In carrying out the activities 

5 described in paragraph (1), the Secretary— 

6 ‘‘(A) is encouraged to give priority to pro7 grammatically relevant research so that new 

8 tools can be utilized in public health practice; 

9 and 

10 ‘‘(B) may seek input from the Biomedical 

11 Advanced Research and Development Authority 

12 in identifying novel candidates to utilize in the 

13 efforts under this subsection to prevent, diag14 nose, and control tuberculosis.’’; 

15 (3) by redesignating subsections (c) through (h) 

16 as subsections (d) through (i), respectively; 

17 (4) by inserting after subsection (b) the fol18 lowing— 

19 ‘‘(c) GRANTS FOR COORDINATION OF PROGRAMS AND

20 SERVICES FOR PREVENTION, DIAGNOSIS, AND TREAT21 MENT.— 

22 ‘‘(1) GRANTS.—The Secretary, acting through 

23 the Administrator of the Health Resources and Serv24 ices Administration, may award grants to State and 

25 local governments and Federally qualified health 


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1 centers for coordinating the programs and services 

2 of such States, governments, and centers to ensure 

3 timely and appropriate prevention, risk-based screen4 ing, diagnosis, and treatment of latent and active tu5 berculosis. 

6 ‘‘(2) DEFINITION.—In this subsection, the term 

7 ‘Federally qualified health center’ has the meaning 

8 given to such term in section 1861(aa) of the Social 

9 Security Act.’’; 

10 (5) in subsections (d), (e), and (f), as so redes11 ignated, by striking ‘‘(a) or (b)’’ each place it ap12 pears and inserting ‘‘(a), (b), or (c)’’; 

13 (6) in subsection (g)(4), as so redesignated, by 

14 adding at the end the following: 

15 ‘‘(C) REPORT TO CONGRESS.—The Sec16 retary is encouraged to make the reports under 

17 subparagraph (A), or other publications rel18 evant to domestic tuberculosis surveillance, pub19 licly available on the internet website of the 

20 Centers for Disease Control and Prevention and 

21 to disseminate such information to stake22 holders.’’; 

23 (7) in subsection (h), as so redesignated— 

24 (A) in paragraph (1)— 


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1 (i) by striking ‘‘research into new 

2 tools under subsection (b)(2)’’ and insert3 ing ‘‘the research, investigations, experi4 ments, demonstrations, and studies in 

5 health science under subsection (b)(1)(B)’’; 

6 and 

7 (ii) by inserting ‘‘ensuring access to 

8 the products developed as a result of such 

9 research, investigations, experiments, dem10 onstrations, and studies and’’ after ‘‘advice 

11 regarding’’; and 

12 (B) in paragraph (3)— 

13 (i) by redesignating subparagraphs 

14 (D) and (E) as subparagraphs (E) and 

15 (F), respectively; and 

16 (ii) by inserting after subparagraph 

17 (C) the following: 

18 ‘‘(D) members of the Biomedical Advanced 

19 Research and Development Authority;’’; and 

20 (8) in subsection (i)(1)(A), as so redesignated, 

21 by striking ‘‘$200,000,000’’ and all that follows 

22 through the period and inserting ‘‘$142,200,000 for 

23 fiscal year 2020, $195,700,000 for fiscal year 2021, 

24 $225,000,000 for fiscal year 2022, $236,250,000 for 


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1 fiscal year 2023, $248,062,500 for fiscal year 2024, 

2 and $260,465,625 for fiscal year 2025.’’. 

3 (b) NIH TUBERCULOSIS ACTIVITIES.—Section 

4 424C(b) of the Public Health Service Act (42 U.S.C. 

5 285b–7c(b)) is amended by striking paragraph (1) and in6 serting the following: 

7 ‘‘(1) enhancing basic, clinical, and operational 

8 research on tuberculosis, including with respect to— 

9 ‘‘(A) drug-resistant tuberculosis; 

10 ‘‘(B) infection with tuberculosis and la11 tency and progression of tuberculosis; and 

12 ‘‘(C) pediatric tuberculosis;’’. 

13 SEC. 3. GAO STUDY. 

14 Not later than 2 years after the date of enactment 

15 of this Act, the Comptroller General of the United States 

16 shall issue a report on the coordination of efforts in the 

17 United States to— 

18 (1) prevent, control, and eliminate tuberculosis; 

19 and 

20 (2) implement the activities under section 317E 

21 of the Public Health Service Act (42 U.S.C. 247b– 

22 6), as amended by this Act, and the National Action 

23 Plan for Combating Multidrug-Resistant Tuber24 culosis, issued in December 2015. 

Æ 


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