II 

Calendar No. 415 

110TH CONGRESS 

1ST SESSION S. 968 

[Report No. 110–193] 

To amend the Foreign Assistance Act of 1961 to provide increased assistance 

for the prevention, treatment, and control of tuberculosis, and for other 

purposes. 

IN THE SENATE OF THE UNITED STATES 

MARCH 22, 2007 

Mrs. BOXER (for herself, Mr. SMITH, Mr. DURBIN, Mr. BROWN, Ms. 

STABENOW, Mrs. MURRAY, Mrs. CLINTON, Mr. BINGAMAN, Mr. MENENDEZ, Ms. CANTWELL, Mr. LEVIN, Mr. SANDERS, Mr. JOHNSON, and Mr. 

LAUTENBERG) introduced the following bill; which was read twice and referred to the Committee on Foreign Relations 

OCTOBER 9, 2007 

Reported, under authority of the order of the Senate of October 4, 2007, by 

Mr. BIDEN, with an amendment 

[Strike out all after the enacting clause and insert the part printed in italic] 

A BILL 

To amend the Foreign Assistance Act of 1961 to provide 

increased assistance for the prevention, treatment, and 

control of 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, 

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1 SECTION 1. SHORT TITLE. 

2 This Act may be cited as the ‘‘Stop Tuberculosis 

3 (TB) Now Act of 2007’’. 

4 SEC. 2. FINDINGS. 

5 Congress finds the following: 

6 (1) Tuberculosis is one of the greatest infec7 tious causes of death of adults worldwide, killing 1.6 

8 million people per year—one person every 15 sec9 onds. 

10 (2) One-third of the world’s population is in11 fected with the tuberculosis bacterium and an esti12 mated 8.8 million individuals develop active tuber13 culosis each year. 

14 (3) Tuberculosis is the leading infectious killer 

15 among individuals who are HIV-positive due to their 

16 weakened immune systems, and it is estimated that 

17 one-third of people with HIV infection have tuber18 culosis. 

19 (4) Today, tuberculosis is a leading killer of 

20 women of reproductive age. 

21 (5) There are 22 countries that account for 80 

22 percent of the world’s burden of tuberculosis. The 

23 People’s Republic of China and India account for 36 

24 percent of all estimated new tuberculosis cases each 

25 year. 

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1 (6) Driven by the HIV/AIDS pandemic, inci2 dence rates of tuberculosis in Africa have more than 

3 doubled on average since 1990, making it the only 

4 region in the world in which tuberculosis rates are 

5 not currently stabilized or declining. The problem is 

6 so pervasive that in August 2005, African Health 

7 Ministers and the World Health Organization 

8 (WHO) declared tuberculosis to be an emergency in 

9 Africa. 

10 (7) The wide extent of drug resistance, includ11 ing both multi-drug resistant tuberculosis (MDR– 

12 TB) and extensively drug resistant tuberculosis 

13 (XDR–TB), represents both a critical challenge to 

14 the global control of tuberculosis and a serious 

15 worldwide public health threat. XDR–TB, which is 

16 characterized as being MDR–TB with additional re17 sistance to multiple second-line anti-tuberculosis 

18 drugs, is associated with worst treatment outcomes 

19 of any form of tuberculosis. XDR–TB is converging 

20 with the HIV epidemic, undermining gains in HIV 

21 prevention and treatment programs and requires ur22 gent interventions. Drug resistance surveillance re23 ports have confirmed the serious scale and spread of 

24 tuberculosis with XDR–TB strains confirmed on six 

25 continents. Demonstrating the lethality of XDR–TB, 

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1 an initial outbreak in Tugela Ferry, South Africa 

2 killed 52 of 53 patients with hundreds more cases 

3 reported since. Of the world’s regions, sub-Saharan 

4 Africa faces the greatest gap in capacity to prevent, 

5 find, and treat XDR–TB. 

6 (8) With more than 50 percent of tuberculosis 

7 cases in the United States attributable to foreign8 born individuals and with the increase in inter9 national travel, commerce, and migration, elimi10 nation of tuberculosis in the United States depends 

11 on efforts to control the disease in developing coun12 tries. Recent research has shown that to invest in 

13 tuberculosis control abroad, where treatment and 

14 program costs are significantly cheaper than in the 

15 United States, would be a cost-effective strategy to 

16 reduce tuberculosis-related morbidity and mortality 

17 domestically. 

18 (9) The threat that tuberculosis poses for 

19 Americans derives from the global spread of tuber20 culosis and the emergence and spread of strains of 

21 multi-drug resistant tuberculosis and extensively 

22 drug resistant tuberculosis, which are far more 

23 deadly, and more difficult and costly to treat. 

24 (10) DOTS (Directly Observed Treatment 

25 Short-course) is one of the most cost-effective health 

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1 interventions available today and is a core compo2 nent of the new Stop TB Strategy. 

3 (11) The Stop TB Strategy, developed by the 

4 World Health Organization, builds on the success of 

5 DOTS and ongoing challenges so as to serve all 

6 those in need and reach targets for prevalence, mor7 tality, and incidence reduction. The Stop TB Strat8 egy includes six components: 

9 (A) Pursuing high-quality expansion and 

10 enhancement of DOTS coverage. 

11 (B) Implementing tuberculosis and HIV 

12 collaborative activities, preventing and control13 ling multi-drug resistant tuberculosis, and ad14 dressing other special challenges. 

15 (C) Contributing to the strengthening of 

16 health systems. 

17 (D) Engaging all health care providers, in18 cluding promotion of the International Stand19 ards for Tuberculosis Care. 

20 (E) Empowering individuals with tuber21 culosis and communities. 

22 (F) Enabling and promoting research to 

23 develop new diagnostics, drugs, vaccines, and 

24 program-based operational research relating to 

25 tuberculosis. 

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1 (12) The Global Plan to Stop TB 2006–2015: 

2 Actions for Life is a comprehensive plan developed 

3 by the Stop TB Partnership that sets out the ac4 tions necessary to achieve the millennium develop5 ment goal of cutting tuberculosis deaths and disease 

6 burden in half by 2015 and thus eliminate tuber7 culosis as a global health problem by 2050. 

8 (13) While innovations such as the Global Tu9 berculosis Drug Facility have enabled low-income 

10 countries to treat a standard case of tuberculosis 

11 with drugs that cost as little as $16 for a full course 

12 of treatment, there are still millions of individuals 

13 with no access to effective treatment. 

14 (14) As the global resource investment in fight15 ing tuberculosis increases, partner nations and inter16 national institutions must commit to a cor17 responding increase in the technical and program as18 sistance necessary to ensure that the most effective 

19 and efficient tuberculosis treatments are provided. 

20 (15) The Global Fund to Fight AIDS, Tuber21 culosis and Malaria is an important global partner22 ship established to combat these three infectious dis23 eases that together kill millions of people a year. Ex24 pansion of effective tuberculosis treatment programs 

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1 vestment, along with integrated efforts to address 

2 HIV and tuberculosis in areas of high prevalence. 

3 (16) The Centers for Disease Control and Pre4 vention (CDC) is actively involved with global tuber5 culosis control efforts since the global tuberculosis 

6 epidemic directly impacts tuberculosis in the United 

7 States, and because Congress has strongly urged the 

8 CDC each year to increase its involvement with 

9 international tuberculosis control efforts. 

10 (17) The CDC is assisting countries with a high 

11 burden of tuberculosis to— 

12 (A) implement the World Health Organiza13 tion-recommended control strategies by improv14 ing the capacity to diagnose and cure individ15 uals with tuberculosis; 

16 (B) improve the capacity to diagnose, 

17 treat, and prevent tuberculosis in HIV-infected 

18 individuals and individuals with multi-drug re19 sistant tuberculosis and extensively drug resist20 ant tuberculosis; and 

21 (C) conduct programmatically-relevant 

22 clinical and operational research to identify and 

23 evaluate new diagnostics, treatment regimes, 

24 and interventions to control tuberculosis. 

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1 SEC. 3. ASSISTANCE TO COMBAT TUBERCULOSIS. 

2 (a) POLICY.—Section 104B(b) of the Foreign Assist3 ance Act of 1961 (22 U.S.C. 2151b–3(b)) is amended to 

4 read as follows: 

5 ‘‘(b) POLICY.—It is a major objective of the foreign 

6 assistance program of the United States to control tuber7 culosis. In all countries in which the Government of the 

8 United States has established development programs, par9 ticularly in countries with the highest burden of tuber10 culosis and other countries with high rates of tuberculosis, 

11 the United States Government should prioritize the 

12 achievement of the following goals by not later than De13 cember 31, 2015: 

14 ‘‘(1) Reduce by half the tuberculosis death and 

15 disease burden from the 1990 baseline. 

16 ‘‘(2) Sustain or exceed the detection of at least 

17 70 percent of sputum smear-positive cases of tuber18 culosis and the cure of at least 85 percent of those 

19 cases detected.’’. 

20 (b) AUTHORIZATION.—Section 104B(c) of the For21 eign Assistance Act of 1961 (22 U.S.C. 2151b–3(c)) is 

22 amended— 

23 (1) in the heading, by striking ‘‘AUTHORIZA24 TION’’ and inserting ‘‘ASSISTANCE REQUIRED’’; and 

25 (2) by striking ‘‘is authorized to’’ and inserting 

26 ‘‘shall’’. 

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1 (c) PRIORITY TO STOP TB STRATEGY.—Section 

2 104B(e) of the Foreign Assistance Act of 1961 (22 U.S.C. 

3 2151b–3(e)) is amended— 

4 (1) in the heading, to read as follows: ‘‘PRI5 ORITY TO STOP TB STRATEGY.—’’; 

6 (2) in the first sentence, by striking ‘‘In fur7 nishing’’ and all that follows through ‘‘, including 

8 funding’’ and inserting the following: 

9 ‘‘(1) PRIORITY.—In furnishing assistance under 

10 subsection (c), the President shall give priority to— 

11 ‘‘(A) activities described in the Stop TB 

12 Strategy, including expansion and enhancement 

13 of DOTS coverage, treatment for individuals in14 fected with both tuberculosis and HIV and 

15 treatment for individuals with multi-drug resist16 ant tuberculosis (MDR–TB), strengthening of 

17 health systems, use of the International Stand18 ards for Tuberculosis Care by all providers, em19 powering individuals with tuberculosis, and ena20 bling and promoting research to develop new 

21 diagnostics, drugs, and vaccines, and program22 based operational research relating to tuber23 culosis; and 

24 ‘‘(B) funding’’; and 

25 (3) in the second sentence— 

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1 (A) by striking ‘‘In order to’’ and all that 

2 follows through ‘‘not less than’’ and inserting 

3 the following: 

4 ‘‘(2) AVAILABILITY OF AMOUNTS.—In order to 

5 meet the requirements of paragraph (1), the Presi6 dent— 

7 ‘‘(A) shall ensure that not less than’’; 

8 (B) by striking ‘‘for Directly Observed 

9 Treatment Short-course (DOTS) coverage and 

10 treatment of multi-drug resistant tuberculosis 

11 using DOTS–Plus,’’ and inserting ‘‘to imple12 ment the Stop TB Strategy; and’’; and 

13 (C) by striking ‘‘including’’ and all that 

14 follows and inserting the following: 

15 ‘‘(B) should ensure that not less than 

16 $15,000,000 of the amount made available to 

17 carry out this section for a fiscal year is used 

18 to make a contribution to the Global Tuber19 culosis Drug Facility.’’. 

20 (d) ASSISTANCE FOR WHO AND THE STOP TUBER21 CULOSIS PARTNERSHIP.—Section 104B of the Foreign 

22 Assistance Act of 1961 (22 U.S.C. 2151b–3) is amend23 ed— 

24 (1) by redesignating subsection (f) as sub25 section (g); and 

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1 (2) by inserting after subsection (e) the fol2 lowing new subsection: 

3 ‘‘(f) ASSISTANCE FOR WHO AND THE STOP TUBER4 CULOSIS PARTNERSHIP.—In carrying out this section, the 

5 President, acting through the Administrator of the United 

6 States Agency for International Development, is author7 ized to provide increased resources to the World Health 

8 Organization (WHO) and the Stop Tuberculosis Partner9 ship to improve the capacity of countries with high rates 

10 of tuberculosis and other affected countries to implement 

11 the Stop TB Strategy and specific strategies related to 

12 addressing extensively drug resistant tuberculosis (XDR– 

13 TB).’’. 

14 (e) DEFINITIONS.—Section 104B(g) of the Foreign 

15 Assistance Act of 1961, as redesignated by subsection 

16 (d)(1), is amended— 

17 (1) in paragraph (1), by adding at the end be18 fore the period the following: ‘‘, including low cost 

19 and effective diagnosis, treatment, and monitoring of 

20 tuberculosis, as well as a reliable drug supply, and 

21 a management strategy for public health systems, 

22 with health system strengthening, promotion of the 

23 use of the International Standards for Tuberculosis 

24 Care by all care providers, bacteriology under an ex25 ternal quality assessment framework, short-course 

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1 chemotherapy, and sound reporting and recording 

2 systems’’; and 

3 (2) by adding after paragraph (5) the following 

4 new paragraph: 

5 ‘‘(6) STOP TB STRATEGY.—The term ‘Stop TB 

6 Strategy’ means the six-point strategy to reduce tu7 berculosis developed by the World Health Organiza8 tion. The strategy is described in the Global Plan to 

9 Stop TB 2007–2016: Actions for Life, a comprehen10 sive plan developed by the Stop Tuberculosis Part11 nership that sets out the actions necessary to 

12 achieve the millennium development goal of cutting 

13 tuberculosis deaths and disease burden in half by 

14 2016.’’. 

15 (f) ANNUAL REPORT.—Section 104A(e)(2)(C)(iii) of 

16 the Foreign Assistance Act of 1961 (22 U.S.C. 2151b– 

17 2(e)(2)(C)(iii)) is amended by adding at the end before 

18 the semicolon the following: ‘‘, including the percentage 

19 of such United States foreign assistance provided for diag20 nosis and treatment of individuals with tuberculosis in 

21 countries with the highest burden of tuberculosis, as deter22 mined by the World Health Organization (WHO)’’. 

23 (g) AUTHORIZATION OF APPROPRIATIONS.—There 

24 are authorized to be appropriated to the President not less 

25 than $330,000,000 for fiscal year 2008 and not less than 

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1 $450,000,000 for fiscal year 2009 to carry out section 

2 104B of the Foreign Assistance Act of 1961 (22 U.S.C. 

3 2151b–3), as amended by subsections (a) through (e) of 

4 this section. 

5 SEC. 4. AUTHORIZATION OF APPROPRIATIONS FOR GLOB6 AL TUBERCULOSIS ACTIVITIES OF THE CEN7 TERS FOR DISEASE CONTROL AND PREVEN8 TION. 

9 For the purpose of carrying out global tuberculosis 

10 activities through the Centers for Disease Control and 

11 Prevention, there are authorized to be appropriated 

12 $70,000,000 for fiscal year 2008 and $100,000,000 for 

13 fiscal year 2009. Such authorization of appropriations is 

14 in addition to other authorizations of appropriations that 

15 are available for such purposes. Amounts appropriated 

16 pursuant to the authorization of appropriations under this 

17 section shall remain available until expended. 

18 SECTION 1. SHORT TITLE. 

19 This Act may be cited as the ‘‘Stop Tuberculosis (TB) 

20 Now Act of 2007’’. 

21 SEC. 2. FINDINGS. 

22 Congress finds the following: 

23 (1) Tuberculosis is one of the greatest infectious 

24 causes of death of adults worldwide, killing 1.6 mil25 lion people per year—one person every 20 seconds. 

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1 (2) One-third of the world’s population is in2 fected with the tuberculosis bacterium and an esti3 mated 8.8 million individuals develop active tuber4 culosis each year. 

5 (3) Tuberculosis is the leading infectious killer 

6 among individuals who are HIV-positive due to their 

7 weakened immune systems, and it is estimated that 

8 one-third of people with HIV infection have tuber9 culosis. 

10 (4) Today, tuberculosis is a leading killer of 

11 women of reproductive age. 

12 (5) There are 22 countries that account for 80 

13 percent of the world’s burden of tuberculosis. The Peo14 ple’s Republic of China and India account for 36 per15 cent of all estimated new tuberculosis cases each year. 

16 (6) Driven by the HIV/AIDS pandemic, inci17 dence rates of tuberculosis in Africa have more than 

18 doubled on average since 1990. The problem is so per19 vasive that in August 2005, African Health Ministers 

20 and the World Health Organization (WHO) declared 

21 tuberculosis to be an emergency in Africa. 

22 (7) The wide extent of drug resistance, including 

23 both multi-drug resistant tuberculosis (MDR–TB) 

24 and extensively drug resistant tuberculosis (XDR– 

25 TB), represents both a critical challenge to the global 

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1 control of tuberculosis and a serious worldwide public 

2 health threat. XDR–TB, which is characterized as 

3 being MDR–TB with additional resistance to mul4 tiple second-line anti-tuberculosis drugs, is associated 

5 with worst treatment outcomes of any form of tuber6 culosis. XDR–TB is converging with the HIV epi7 demic, undermining gains in HIV prevention and 

8 treatment programs and requires urgent interven9 tions. Drug resistance surveillance reports have con10 firmed the serious scale and spread of tuberculosis 

11 with XDR–TB strains confirmed on six continents. 

12 Demonstrating the lethality of XDR–TB, an initial 

13 outbreak in Tugela Ferry, South Africa killed 52 of 

14 53 patients with hundreds more cases reported since. 

15 Of the world’s regions, sub-Saharan Africa faces the 

16 greatest gap in capacity to prevent, find, and treat 

17 XDR–TB. 

18 (8) With more than 50 percent of tuberculosis 

19 cases in the United States attributable to foreign-born 

20 individuals and with the increase in international 

21 travel, commerce, and migration, elimination of tu22 berculosis in the United States depends on efforts to 

23 control the disease in developing countries. Recent re24 search has shown that to invest in tuberculosis control 

25 abroad, where treatment and program costs are sigmstockstill on PROD1PC66 with BILLS

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1 nificantly cheaper than in the United States, would 

2 be a cost-effective strategy to reduce tuberculosis-re3 lated morbidity and mortality domestically. 

4 (9) The threat that tuberculosis poses for Ameri5 cans derives from the global spread of tuberculosis 

6 and the emergence and spread of strains of multi7 drug resistant tuberculosis and extensively drug re8 sistant tuberculosis, which are far more deadly, and 

9 more difficult and costly to treat. 

10 (10) DOTS (Directly Observed Treatment Short11 course) is one of the most cost-effective health inter12 ventions available today and is a core component of 

13 the new Stop TB Strategy. 

14 (11) The Stop TB Strategy, developed by the 

15 World Health Organization, builds on the success of 

16 DOTS and ongoing challenges so as to serve all those 

17 in need and reach targets for prevalence, mortality, 

18 and incidence reduction. The Stop TB Strategy in19 cludes six components: 

20 (A) Pursuing high-quality expansion and 

21 enhancement of DOTS coverage. 

22 (B) Implementing tuberculosis and HIV col23 laborative activities, preventing and controlling 

24 multi-drug resistant tuberculosis, and addressing 

25 other special challenges. 

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1 (C) Contributing to the strengthening of 

2 health systems. 

3 (D) Engaging all health care providers, in4 cluding promotion of the International Stand5 ards for Tuberculosis Care. 

6 (E) Empowering individuals with tuber7 culosis and communities. 

8 (F) Enabling and promoting research to de9 velop new diagnostics, drugs, vaccines, and pro10 gram-based operational research relating to tu11 berculosis. 

12 (12) The Global Plan to Stop TB 2006–2015: 

13 Actions for Life is a comprehensive plan developed by 

14 the Stop TB Partnership that sets out the actions nec15 essary to achieve the millennium development goal of 

16 cutting tuberculosis deaths and disease burden in half 

17 by 2015 and thus eliminate tuberculosis as a global 

18 health problem by 2050. 

19 (13) While innovations such as the Global Tuber20 culosis Drug Facility have enabled low-income coun21 tries to treat a standard case of tuberculosis with 

22 drugs that cost as little as $16 for a full course of 

23 treatment, there are still millions of individuals with 

24 no access to effective treatment. 

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1 (14) As the global resource investment in fighting 

2 tuberculosis increases, partner nations and inter3 national institutions must commit to a corresponding 

4 increase in the technical and program assistance nec5 essary to ensure that the most effective and efficient 

6 tuberculosis treatments are provided. 

7 (15) The Global Fund to Fight AIDS, Tuber8 culosis and Malaria is an important global partner9 ship established to combat these three infectious dis10 eases that together kill millions of people a year. Ex11 pansion of effective tuberculosis treatment programs 

12 constitutes a major component of Global Fund invest13 ment, along with integrated efforts to address HIV 

14 and tuberculosis in areas of high prevalence. 

15 (16) The United States Agency for International 

16 Development (USAID) and the Centers for Disease 

17 Control and Prevention (CDC) are actively involved 

18 with global tuberculosis control efforts. Because the 

19 global tuberculosis epidemic directly impacts tuber20 culosis in the United States, Congress has urged the 

21 CDC each year to increase its involvement with inter22 national tuberculosis control efforts. 

23 (17) USAID is the lead United States Govern24 ment agency involved in international efforts to pre25 vent, treat, and control tuberculosis, working in close 

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1 partnership with the CDC and with the President’s 

2 Emergency Plan for HIV/AIDS Relief. USAID’s goal 

3 is to contribute to the global reduction of morbidity 

4 and mortality associated with tuberculosis by build5 ing country capacity to prevent and cure the disease 

6 and achieve global targets of 70 percent case detection 

7 and 85 percent treatment success rates. USAID pro8 vides support for tuberculosis programs in countries 

9 that have a high burden of tuberculosis, high TB/HIV 

10 prevalence, or have high risk of MDR–TB. 

11 (18) The CDC is assisting countries with a high 

12 burden of tuberculosis to— 

13 (A) implement the World Health Organiza14 tion-recommended control strategies by improv15 ing the capacity to diagnose and cure individ16 uals with tuberculosis; 

17 (B) improve the capacity to diagnose, treat, 

18 and prevent tuberculosis in HIV-infected indi19 viduals and individuals with multi-drug resist20 ant tuberculosis and extensively drug resistant 

21 tuberculosis; and 

22 (C) conduct programmatically-relevant clin23 ical and operational research to identify and 

24 evaluate new diagnostics, treatment regimes, and 

25 interventions to control tuberculosis. 

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1 SEC. 3. ASSISTANCE TO COMBAT TUBERCULOSIS. 

2 (a) POLICY.—Section 104B(b) of the Foreign Assist3 ance Act of 1961 (22 U.S.C. 2151b–3(b)) is amended to read 

4 as follows: 

5 ‘‘(b) POLICY.—It is a major objective of the foreign as6 sistance program of the United States to control tuber7 culosis. In all countries in which the Government of the 

8 United States has established development programs, par9 ticularly in countries with the highest burden of tuber10 culosis and other countries with high rates of tuberculosis, 

11 the United States Government should prioritize the achieve12 ment of the following goals by not later than December 31, 

13 2015: 

14 ‘‘(1) Reduce by half the tuberculosis death and 

15 disease burden from the 1990 baseline. 

16 ‘‘(2) Sustain or exceed the detection of at least 

17 70 percent of sputum smear-positive cases of tuber18 culosis and the cure of at least 85 percent of those 

19 cases detected.’’. 

20 (b) AUTHORIZATION.—Section 104B(c) of the Foreign 

21 Assistance Act of 1961 (22 U.S.C. 2151b–3(c)) is amend22 ed— 

23 (1) in the heading, by striking ‘‘AUTHORIZA24 TION’’ and inserting ‘‘ASSISTANCE REQUIRED’’; and 

25 (2) by striking ‘‘is authorized to’’ and inserting 

26 ‘‘shall’’. 

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1 (c) PRIORITY TO STOP TB STRATEGY.—Section 

2 104B(e) of the Foreign Assistance Act of 1961 (22 U.S.C. 

3 2151b–3(e)) is amended— 

4 (1) in the heading, to read as follows: ‘‘PRIORITY

5 TO STOP TB STRATEGY.—’’; 

6 (2) in the first sentence, by striking ‘‘In fur7 nishing’’ and all that follows through ‘‘, including 

8 funding’’ and inserting the following: 

9 ‘‘(1) PRIORITY.—In furnishing assistance under 

10 subsection (c), the President shall give priority to— 

11 ‘‘(A) activities described in the Stop TB 

12 Strategy, including expansion and enhancement 

13 of DOTS coverage, treatment for individuals in14 fected with both tuberculosis and HIV and treat15 ment for individuals with multi-drug resistant 

16 tuberculosis (MDR–TB), strengthening of health 

17 systems, use of the International Standards for 

18 Tuberculosis Care by all providers, empowering 

19 individuals with tuberculosis, and enabling and 

20 promoting research to develop new diagnostics, 

21 drugs, and vaccines, and program-based oper22 ational research relating to tuberculosis; and 

23 ‘‘(B) funding’’; and 

24 (3) in the second sentence— 

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1 (A) by striking ‘‘In order to’’ and all that 

2 follows through ‘‘not less than’’ and inserting the 

3 following: 

4 ‘‘(2) AVAILABILITY OF AMOUNTS.—In order to 

5 meet the requirements of paragraph (1), the Presi6 dent— 

7 ‘‘(A) shall ensure that not less than’’; 

8 (B) by striking ‘‘for Directly Observed 

9 Treatment Short-course (DOTS) coverage and 

10 treatment of multi-drug resistant tuberculosis 

11 using DOTS–Plus,’’ and inserting ‘‘to implement 

12 the Stop TB Strategy; and’’; and 

13 (C) by striking ‘‘including’’ and all that fol14 lows and inserting the following: 

15 ‘‘(B) should ensure that $15,000,000 of the 

16 amount made available to carry out this section 

17 for a fiscal year is used to make a contribution 

18 to the Global Tuberculosis Drug Facility.’’. 

19 (d) ASSISTANCE FOR WHO AND THE STOP TUBER20 CULOSIS PARTNERSHIP.—Section 104B of the Foreign As21 sistance Act of 1961 (22 U.S.C. 2151b–3) is amended— 

22 (1) by redesignating subsection (f) as subsection 

23 (g); and 

24 (2) by inserting after subsection (e) the following 

25 new subsection: 

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1 ‘‘(f) ASSISTANCE FOR WHO AND THE STOP TUBER2 CULOSIS PARTNERSHIP.—In carrying out this section, the 

3 President, acting through the Administrator of the United 

4 States Agency for International Development, is authorized 

5 to provide increased resources to the World Health Organi6 zation (WHO) and the Stop Tuberculosis Partnership to 

7 improve the capacity of countries with high rates of tuber8 culosis and other affected countries to implement the Stop 

9 TB Strategy and specific strategies related to addressing 

10 extensively drug resistant tuberculosis (XDR–TB).’’. 

11 (e) DEFINITIONS.—Section 104B(g) of the Foreign As12 sistance Act of 1961, as redesignated by subsection (d)(1), 

13 is amended— 

14 (1) in paragraph (1), by adding at the end be15 fore the period the following: ‘‘, including low cost 

16 and effective diagnosis, treatment, and monitoring of 

17 tuberculosis, as well as a reliable drug supply, and a 

18 management strategy for public health systems, with 

19 health system strengthening, promotion of the use of 

20 the International Standards for Tuberculosis Care by 

21 all care providers, bacteriology under an external 

22 quality assessment framework, short-course chemo23 therapy, and sound reporting and recording systems’’; 

24 and 

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1 (2) by adding after paragraph (5) the following 

2 new paragraph: 

3 ‘‘(6) STOP TB STRATEGY.—The term ‘Stop TB 

4 Strategy’ means the six-point strategy to reduce tu5 berculosis developed by the World Health Organiza6 tion. The strategy is described in the Global Plan to 

7 Stop TB 2007–2016: Actions for Life, a comprehen8 sive plan developed by the Stop Tuberculosis Partner9 ship that sets out the actions necessary to achieve the 

10 millennium development goal of cutting tuberculosis 

11 deaths and disease burden in half by 2016.’’. 

12 (f) ANNUAL REPORT.—Section 104A(e)(2)(C)(iii) of 

13 the Foreign Assistance Act of 1961 (22 U.S.C. 2151b– 

14 2(e)(2)(C)(iii)) is amended by adding at the end before the 

15 semicolon the following: ‘‘, including the percentage of such 

16 United States foreign assistance provided for diagnosis and 

17 treatment of individuals with tuberculosis in countries with 

18 the highest burden of tuberculosis, as determined by the 

19 World Health Organization (WHO)’’. 

20 (g) AUTHORIZATION OF APPROPRIATIONS.— 

21 (1) IN GENERAL.—There are authorized to be ap22 propriated to the President up to $400,000,000 for 

23 fiscal year 2008 and up to $550,000,000 for fiscal 

24 year 2009 to carry out section 104B of the Foreign 

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1 Assistance Act of 1961 (22 U.S.C. 2151b–3), as 

2 amended by subsections (a) through (e) of this section. 

3 (2) AVAILABILITY FOR CDC.—Of the amounts ap4 propriated pursuant to the authorization of appro5 priations under paragraph (1), up to $70,000,000 

6 may be available for fiscal year 2008 and up to 

7 $100,000,000 may be available for fiscal year 2009 

8 for the Centers for Disease Control and Prevention for 

9 the purpose of carrying out global tuberculosis activi10 ties. 

11 (3) AVAILABILITY UNTIL EXPENDITURE.— 

12 Amounts appropriated pursuant to the authorization 

13 of appropriations under paragraph (1) shall remain 

14 available until expended. 

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Calendar No. 415 

110TH CONGRESS 

1ST SESSION S. 968 

[Report No. 110

–193] 

A BILL 

To amend the Foreign Assistance Act of 1961 to 

other purposes. treatment, and control of tuberculosis, and for provide increased assistance for the prevention, 

OCTOBER 9, 2007 

Reported with an amendment 

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