I 

108TH CONGRESS 

1ST SESSION H. R. 2068

To amend the Public Health Service Act with respect to making progress 

toward the goal of eliminating tuberculosis, and for other purposes. 

IN THE HOUSE OF REPRESENTATIVES 

MAY 13, 2003

Mr. BROWN of Ohio (for himself and Mrs. WILSON of New Mexico) introduced 

the following bill; which was referred to the Committee on Energy and 

Commerce 

A BILL

To amend the Public Health Service Act with respect to 

making progress toward the goal of 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 Tuber5 culosis Elimination Act of 2003’’. 
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1 TITLE I—INTERAGENCY 

2 COLLABORATION 

3 SEC. 101. ADVISORY COUNCIL FOR THE ELIMINATION OF 

4 TUBERCULOSIS. 

5 Section 317E(f) of the Public Health Service Act (42 

6 U.S.C. 247b–6(f)) is amended—

7 (1) by redesignating paragraph (5) as para8 graph (6); and 

9 (2) by striking paragraphs (2) through (4), and 

10 inserting the following: 

11 ‘‘(2) DUTIES.—For the purpose of making 

12 progress toward the goal of eliminating tuberculosis 

13 from the United States, the Council shall provide to 

14 the Secretary and other appropriate Federal officials 

15 advice on coordinating the activities of the Public 

16 Health Service and other Federal agencies that re17 late to such disease and on efficiently utilizing the 

18 Federal resources involved. 

19 ‘‘(3) NATIONAL PLAN.—In carrying out para20 graph (2), the Council, in consultation with appro21 priate public and private entities, shall make rec22 ommendations on the development, revision, and im23 plementation of a national plan to eliminate tuber24 culosis in the United States. In carrying out this 

25 paragraph, the Council shall—
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1 ‘‘(A) consider the recommendations of the 

2 Institute of Medicine regarding the elimination 

3 of tuberculosis; 

4 ‘‘(B) address the development and applica5 tion of new technologies; and 

6 ‘‘(C) review the extent to which progress 

7 has been made toward eliminating tuberculosis. 

8 ‘‘(4) GLOBAL ACTIVITIES.—In carrying out 

9 paragraph (2), the Council, in consultation with ap10 propriate public and private entities, shall make rec11 ommendations for the development and implementa12 tion of a plan to guide the involvement of the United 

13 States in global and cross border tuberculosis-control 

14 activities, including recommendations regarding poli15 cies, strategies, objectives, and priorities. Such rec16 ommendations for the plan shall have a focus on 

17 countries where a high incidence of tuberculosis di18 rectly affects the United States, such as Mexico, and 

19 on access to a comprehensive package of tuberculosis 

20 control measures, as defined by the World Health 

21 Organization directly observed treatment, short 

22 course strategy (commonly known as DOTS). 

23 ‘‘(5) COMPOSITION.—The Council shall be com24 posed of—
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1 ‘‘(A) representatives from the Centers for 

2 Disease Control and Prevention, the National 

3 Institutes of Health, the Agency for Healthcare 

4 Research and Quality, the Health Resources 

5 and Services Administration, the U.S.-Mexico 

6 Border Health Commission, and other Federal 

7 departments and agencies that carry out signifi8 cant activities relating to tuberculosis; and 

9 ‘‘(B) members appointed from among indi10 viduals who are not officers or employees of the 

11 Federal Government.’’. 

12 TITLE II—CENTERS FOR DIS13 EASE CONTROL AND PREVEN14 TION 

15 SEC. 201. NATIONAL PROGRAM FOR TUBERCULOSIS ELIMI16 NATION. 

17 Section 317E of the Public Health Service Act (42 

18 U.S.C. 247b–6) is amended—

19 (1) by striking the heading for the section and 

20 inserting the following: 

21 ‘‘NATIONAL PROGRAM FOR TUBERCULOSIS

22 ELIMINATION’’; 

23 (2) by amending subsection (b) to read as fol24 lows: 

25 ‘‘(b) RESEARCH, DEMONSTRATION PROJECTS, EDU26 CATION, AND TRAINING.—With respect to the prevention, 
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1 control, and elimination of tuberculosis, the Secretary 

2 may, directly or through grants to public or nonprofit pri3 vate entities, carry out the following: 

4 ‘‘(1) Research, with priority given to research 

5 concerning—

6 ‘‘(A) diagnosis and treatment of latent in7 fection of tuberculosis; 

8 ‘‘(B) strains of tuberculosis resistant to 

9 drugs; 

10 ‘‘(C) cases of tuberculosis that affect cer11 tain populations; and 

12 ‘‘(D) clinical trials, including a tuberculosis 

13 trials consortium. 

14 ‘‘(2) Demonstration projects for—

15 ‘‘(A) the development of regional capabili16 ties for the prevention, control, and elimination 

17 of tuberculosis; and 

18 ‘‘(B) collaboration with the Immigration 

19 and Naturalization Service to identify and treat 

20 immigrants with active or latent tuberculosis in21 fection. 

22 ‘‘(3) Public information and education pro23 grams.
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1 ‘‘(4) Education, training and clinical skills im2 provement activities for health professionals, includ3 ing allied health personnel.

4 ‘‘(5) Support of model centers to carry out ac5 tivities under paragraphs (1) through (4). 

6 ‘‘(6) Collaboration with international organiza7 tions and foreign countries in carrying out such ac8 tivities, including coordinating activities through the 

9 Committee on Interagency Collaboration for Tuber10 culosis Elimination.’’; 

11 (3) in subsection (f), by adding at the end the 

12 following: 

13 ‘‘(4) ANNUAL REPORTS.—The Council shall an14 nually submit to the Congress and the Secretary a 

15 report on the activities carried out under this sub16 section. The report shall include the opinion of the 

17 Council on the extent to which the recommendations 

18 of the Institute of Medicine regarding tuberculosis 

19 have been implemented.’’; and 

20 (4) by amending subsection (g) to read as fol21 lows: 

22 ‘‘(g) AUTHORIZATION OF APPROPRIATIONS.—For the 

23 purpose of carrying out this section, there are authorized 

24 to be appropriated $528,000,000 for fiscal year 2004, and 
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1 such sums as may be necessary for each of the fiscal years 

2 2005 through 2008.’’. 

3 TITLE III—NATIONAL 

4 INSTITUTES OF HEALTH 

5 SEC. 301. ACTIVITIES OF NATIONAL HEART, LUNG, AND 

6 BLOOD INSTITUTE. 

7 Subpart 2 of part C of title IV of the Public Health 

8 Service Act (42 U.S.C. 285b et seq.) is amended by insert9 ing after section 424B the following section: 

10 ‘‘TUBERCULOSIS

11 ‘‘SEC. 424C. (a) IN GENERAL.—The Director of the 

12 Institute shall expand, intensify, and coordinate research 

13 and related activities of the Institute with respect to tuber14 culosis, including activities toward the goal of eliminating 

15 such disease. 

16 ‘‘(b) CERTAIN ACTIVITIES.—Activities under sub17 section (a) shall include—

18 ‘‘(1) enhancing basic and clinical research on 

19 tuberculosis; and 

20 ‘‘(2) expanding research on the relationship be21 tween such disease and the human immunodeficiency 

22 virus. 

23 ‘‘(c) RESEARCH EDUCATION.—

24 ‘‘(1) TUBERCULOSIS ACADEMIC AWARDS.—The 

25 Director of the Institute may provide awards to fac26 ulty of schools of medicine or osteopathic medicine 
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1 to assist such faculty in developing high quality cur2 ricula in such schools designed to significantly in3 crease the opportunities for interested individuals, 

4 including students of the school and practicing phy5 sicians and nurses, to learn the principles and prac6 tices of preventing, managing, and controlling tuber7 culosis. 

8 ‘‘(2) TUBERCULOSIS/PULMONARY INFECTION

9 AWARDS.—The Director of the Institute may provide 

10 awards to support the career development of clini11 cally trained professionals who are committed to re12 search regarding pulmonary infections and tuber13 culosis by providing for supervised study and re14 search. 

15 ‘‘(3) AUTHORIZATION OF APPROPRIATIONS.—

16 ‘‘(A) TUBERCULOSIS ACADEMIC

17 AWARDS.—For the purpose of carrying out 

18 paragraph (1), there are authorized to be ap19 propriated $5,000,000 for fiscal year 2004, and 

20 such sums as may be necessary for each of the 

21 fiscal years 2005 through 2008. 

22 ‘‘(B) TUBERCULOSIS/PULMONARY INFEC23 TION AWARDS.—For the purpose of carrying 

24 out paragraph (2), there are authorized to be 

25 appropriated $5,000,000 for fiscal year 2004, 
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1 and such sums as may be necessary for each of 

2 the fiscal years 2005 through 2008.’’. 

3 SEC. 302. ACTIVITIES OF NATIONAL INSTITUTE OF AL4 LERGY AND INFECTIOUS DISEASES. 

5 Section 447A of the Public Health Service Act (42 

6 U.S.C. 285f–2) is amended—

7 (1) by redesignating subsection (b) as sub8 section (c); 

9 (2) by inserting after subsection (a) the fol10 lowing subsection: 

11 ‘‘(b) Activities under subsection (a) shall include ac12 tivities to develop a tuberculosis vaccine. Such activities 

13 shall be carried out in accordance with the blueprint for 

14 tuberculosis vaccine development described in the report 

15 prepared pursuant to the workshop convened in March 

16 1998 by the Advisory Council for Elimination of Tuber17 culosis, the Director of the National Vaccine Program, 

18 and the Director of the Institute.’’; and 

19 (3) in subsection (c) (as so redesignated), in the 

20 first sentence—

21 (A) by striking ‘‘and’’ after ‘‘1994,’’; and 

22 (B) by inserting before the period the fol23 lowing: ‘‘, $240,000,000 for fiscal year 2004, 

24 and such sums as may be necessary for each of 

25 the fiscal years 2005 through 2008’’. 
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1 SEC. 303. JOHN E. FOGARTY INTERNATIONAL CENTER FOR 

2 ADVANCED STUDY IN THE HEALTH 

3 SCIENCES. 

4 Section 482 of the Public Health Service Act (42 

5 U.S.C. 287b) is amended—

6 (1) by inserting ‘‘(a) IN GENERAL.—’’ before 

7 ‘‘The general purpose’’; 

8 (2) in subsection (a) (as so designated), by in9 serting after ‘‘Health Sciences’’ the following: ‘‘(in 

10 this subpart referred to as the ‘Center’)’’; and 

11 (3) by adding at the end the following sub12 section: 

13 ‘‘(b) TUBERCULOSIS.—

14 ‘‘(1) IN GENERAL.—In carrying out subsection 

15 (a) with respect to tuberculosis, the Center shall ex16 pand, intensify, and coordinate international activi17 ties of the Center for research and training. 

18 ‘‘(2) INTERNATIONAL TRAINING PROGRAM.—In 

19 carrying out paragraph (1), the Center shall carry 

20 out an international training program regarding tu21 berculosis. Such program shall be modeled after the 

22 international training program carried out by the 

23 Center with respect to the human immunodeficiency 

24 virus.’’. 
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1 SEC. 304. LOAN REPAYMENT PROGRAMS REGARDING RE2 SEARCH ON TUBERCULOSIS. 

3 Part G of title IV of the Public Health Service Act 

4 (42 U.S.C. 288 et seq.) is amended—

5 (1) by redesignating the second section 487F as 

6 section 487G; and 

7 (2) by inserting after section 487G (as so re8 designated) the following section: 

9 ‘‘LOAN REPAYMENTS REGARDING RESEARCH ON

10 TUBERCULOSIS

11 ‘‘SEC. 487H. In carrying out sections 487C, 487E, 

12 and 487F, the Secretary shall seek to ensure that, for fis13 cal year 2004 and subsequent fiscal years, a portion of 

14 amounts appropriated to carry out such sections is re15 served for the purpose of entering into contracts under 

16 which (in accordance with the section involved) individuals 

17 will conduct research on tuberculosis.’’.

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