II 

118TH CONGRESS 

1ST SESSION S. 288 

To prevent, treat, and cure tuberculosis globally. 

IN THE SENATE OF THE UNITED STATES 

FEBRUARY 7, 2023 

Mr. MENENDEZ (for himself and Mr. YOUNG) introduced the following bill; 

which was read twice and referred to the Committee on Foreign Relations 

A BILL 

To prevent, treat, and cure tuberculosis globally. 

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 ‘‘End Tuberculosis Now 

5 Act of 2023’’. 

6 SEC. 2. FINDINGS. 

7 Congress makes the following findings: 

8 (1) Tuberculosis (referred to in the Act as 

9 ‘‘TB’’) is a preventable, treatable, and curable dis10 ease, yet more than 25 years after the World Health 

11 Organization declared it to be a public health emer12 gency and called on countries to make scaling up TB 


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1 control a priority, TB remains a deadly health 

2 threat. 

3 (2) In 2021 alone, an estimated 10,600,000 

4 people became ill with TB, 11 percent of whom were 

5 children, and an estimated 1,600,000 of these people 

6 died from the illness. In order to achieve by 2035 

7 the goals of the Political Declaration of the High8 Level Meeting of the General Assembly on the Fight 

9 Against Tuberculosis, adopted by the United Na10 tions General Assembly October 10, 2018, and of 

11 the World Health Organization End TB Strategy, 

12 adopted by the World Health Assembly in 2014, new 

13 and existing tools must be developed and scaled-up. 

(3) More than 1 14 ⁄3 of people who become ill with 

15 TB may be undiagnosed or misdiagnosed, resulting 

16 in unnecessary illness, communicable infections, and 

17 increased mortality. 

18 (4) Since March 2020, the COVID–19 pan19 demic has severely disrupted TB responses in low20 and middle-income countries, stalling and reversing 

21 years of progress made against TB. According to the 

22 World Health Organization, from 2019 to 2020— 

23 (A) global detection of TB dropped by 18 

24 percent; 


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1 (B) an estimated 1,300,000 fewer people 

2 were diagnosed and enrolled on TB treatment; 

3 and 

4 (C) in some countries, TB case notifica5 tions dropped by up to 41 percent, setting 

6 progress back by up to 12 years. 

7 (5) Failure to properly diagnose and treat TB 

8 can lead to death, can exacerbate antimicrobial re9 sistance (a key contributor to rising cases of multi10 drug-resistant TB and extensively drug-resistant 

11 TB), and can increase the probability of the intro12 duction of resistant TB into new geographic areas. 

13 (6) TB programs have played a central role in 

14 responding to COVID–19, including through 

15 leveraging the expertise of medical staff with exper16 tise in TB and lung diseases, the repurposing of TB 

17 hospitals, and the use of the TB rapid molecular 

18 testing platforms and x-ray equipment for multiple 

19 purposes, including the treatment of COVID–19. 

20 (7) With sufficient resourcing, TB program ex21 pertise, infection control, laboratory capacity, active 

22 case finding, and contact investigation can serve as 

23 platforms for respiratory pandemic response against 

24 existing and new infectious respiratory disease with25 out disrupting ongoing TB programs and activities. 


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(8) Globally, only about 1 1 ⁄2 of the 

2 $13,000,000,000 required annually, as outlined in 

3 the Stop TB Partnership’s Global Plan to End TB, 

4 is currently available. 

5 (9) According to estimates by the Global Fund 

6 for AIDS, Tuberculosis, and Malaria, an additional 

7 $3,500,000,000 was needed during 2021 for TB 

8 programs in eligible countries in order to recover 

9 from the negative impacts of COVID–19. 

10 (10) On September 26, 2018, the United Na11 tions convened the first High-Level Meeting of the 

12 General Assembly on the Fight Against Tuber13 culosis, during which 120 countries— 

14 (A) signed a Political Declaration to accel15 erate progress against TB, including through 

16 commitments to increase funding for TB pre17 vention, diagnosis, treatment, and research and 

18 development programs, and to set ambitious 

19 goals to successfully treat 40,000,000 people 

20 with active TB and prevent at least 30,000,000 

21 from becoming ill with TB between 2018 and 

22 2022; and 

23 (B) committed to ‘‘ending the epidemic in 

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1 tional and global collective actions, investments 

2 and innovations urgently to fight this prevent3 able and treatable disease’’, as reflected in 

4 United Nations General Assembly Resolution 

5 73/3. 

6 (11) The United States Government continues 

7 to be a lead funder of global TB research and devel8 opment, contributing 44 percent of the total 

9 $915,000,000 in global funding in 2020, and can 

10 catalyze more investments from other countries. 

11 (12) Working with governments and partners 

12 around the world, USAID’s TB programming has 

13 saved an estimated 74,000,000 lives, demonstrating 

14 the effectiveness of United States programs and ac15 tivities against the illness. 

16 (13) On September 26, 2018, the USAID Ad17 ministrator announced a new performance-based 

18 Global Accelerator to End TB, aimed at catalyzing 

19 investments to meet the treatment target set by the 

20 United Nations High-Level Meeting, further dem21 onstrating the critical role that United States leader22 ship and assistance plays in the fight to eliminate 

23 TB. 

24 (14) It is essential to ensure that efforts among 

25 United States Government agencies, partner nations, 


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1 international organizations, nongovernmental organi2 zations, the private sector, and other actors are com3 plementary and not duplicative in order to achieve 

4 the goal of ending the TB epidemic in all countries. 

5 SEC. 3. UNITED STATES GOVERNMENT ASSISTANCE TO 

6 COMBAT TUBERCULOSIS. 

7 Section 104B of the Foreign Assistance Act of 1961 

8 (22 U.S.C. 2151b–3) is amended to read as follows: 

9 ‘‘SEC. 104B. ASSISTANCE TO COMBAT TUBERCULOSIS. 

10 ‘‘(a) FINDINGS.—Congress makes the following find11 ings: 

12 ‘‘(1) The international spread of tuberculosis 

13 (referred to in this section as ‘TB’) and the deadly 

14 impact of TB’s continued existence constitutes a 

15 continuing challenge. 

16 ‘‘(2) Additional tools and resources are required 

17 to effectively diagnose, prevent, and treat TB. 

18 ‘‘(3) Effectively resourced TB programs can 

19 serve as a critical platform for preventing and re20 sponding to future infectious respiratory disease 

21 pandemics. 

22 ‘‘(b) POLICY.— 

23 ‘‘(1) IN GENERAL.—It is a major objective of 

24 the foreign assistance program of the United States 


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1 to help end the TB public health emergency through 

2 accelerated actions— 

3 ‘‘(A) to support the diagnosis and treat4 ment of all adults and children with all forms 

5 of TB; and 

6 ‘‘(B) to prevent new TB infections from 

7 occurring. 

8 ‘‘(2) SUPPORT FOR GLOBAL PLANS AND OBJEC9 TIVES.—In countries in which the United States 

10 Government has established foreign assistance pro11 grams under this Act, particularly in countries with 

12 the highest burden of TB and other countries with 

13 high rates of infection and transmission of TB, it is 

14 the policy of the United States— 

15 ‘‘(A) to support the objectives of the World 

16 Health Organization End TB Strategy, includ17 ing its goals— 

18 ‘‘(i) to reduce TB deaths by 95 per19 cent by 2035; 

20 ‘‘(ii) to reduce the TB incidence rate 

21 by 90 percent by 2035; and 

22 ‘‘(iii) to reduce the number of families 

23 facing catastrophic health costs due to TB 

24 by 100 percent by 2035; 


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1 ‘‘(B) to support the Stop TB Partnership’s 

2 Global Plan to End TB 2023–2030, including 

3 by providing support for— 

4 ‘‘(i) developing and using innovative 

5 new technologies and therapies to increase 

6 active case finding and rapidly diagnose 

7 and treat children and adults with all 

8 forms of TB, alleviate suffering, and en9 sure TB treatment completion; 

10 ‘‘(ii) expanding diagnosis and treat11 ment in line with the goals established by 

12 the Political Declaration of the High-Level 

13 Meeting of the General Assembly on the 

14 Fight Against Tuberculosis, including— 

15 ‘‘(I) successfully treating 

16 40,000,000 people with active TB by 

17 2023, including 3,500,000 children, 

18 and 1,500,000 people with drug-re19 sistant TB; and 

20 ‘‘(II) diagnosing and treating la21 tent tuberculosis infection, in support 

22 of the global goal of providing preven23 tive therapy to at least 30,000,000 

24 people by 2023, including 4,000,000 

25 children younger than 5 years of age, 


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1 20,000,000 household contacts of peo2 ple affected by TB, and 6,000,000 

3 people living with HIV; 

4 ‘‘(iii) ensuring high-quality TB care 

5 by closing gaps in care cascades, imple6 menting continuous quality improvement 

7 at all levels of care, and providing related 

8 patient support; and 

9 ‘‘(iv) sustainable procurements of TB 

10 commodities to avoid interruptions in sup11 ply, the procurement of commodities of un12 known quality, or payment of excessive 

13 commodity costs in countries impacted by 

14 TB; and 

15 ‘‘(C) to ensure, to the greatest extent prac16 ticable, that United States funding supports ac17 tivities that simultaneously emphasize— 

18 ‘‘(i) the development of comprehensive 

19 person-centered programs, including diag20 nosis, treatment, and prevention strategies 

21 to ensure that— 

22 ‘‘(I) all people sick with TB re23 ceive quality diagnosis and treatment 

24 through active case finding; and 


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1 ‘‘(II) people at high risk for TB 

2 infection are found and treated with 

3 preventive therapies in a timely man4 ner; 

5 ‘‘(ii) robust TB infection control prac6 tices are implemented in all congregate set7 tings, including hospitals and prisons; 

8 ‘‘(iii) the deployment of diagnostic 

9 and treatment capacity— 

10 ‘‘(I) in areas with the highest TB 

11 burdens; and 

12 ‘‘(II) for highly at-risk and im13 poverished populations, including pa14 tient support services; 

15 ‘‘(iv) program monitoring and evalua16 tion based on critical TB indicators, in17 cluding indicators relating to infection con18 trol, the numbers of patients accessing TB 

19 treatment and patient support services, 

20 and preventative therapy for those at risk, 

21 including all close contacts, and treatment 

22 outcomes for all forms of TB; 

23 ‘‘(v) training and engagement of 

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1 come available, and increased support for 

2 training frontline health care workers to 

3 support expanded TB active case finding, 

4 contact tracing, and patient support serv5 ices; 

6 ‘‘(vi) coordination with domestic agen7 cies and organizations to support an ag8 gressive research agenda to develop vac9 cines as well as new tools to diagnose, 

10 treat, and prevent TB globally; 

11 ‘‘(vii) linkages with the private sector 

12 on— 

13 ‘‘(I) research and development of 

14 a vaccine, and on new tools for diag15 nosis and treatment of TB; 

16 ‘‘(II) improving current tools for 

17 diagnosis and treatment of TB, in18 cluding telehealth solutions for pre19 vention and treatment; and 

20 ‘‘(III) training healthcare profes21 sionals on use of the newest and most 

22 effective diagnostic and therapeutic 

23 tools; 


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1 ‘‘(viii) the reduction of barriers to 

2 care, including stigma and treatment and 

3 diagnosis costs, including through— 

4 ‘‘(I) training health workers; 

5 ‘‘(II) sensitizing policy makers; 

6 ‘‘(III) requiring that all relevant 

7 grants and funding agreements in8 clude access and affordability provi9 sions; 

10 ‘‘(IV) supporting education and 

11 empowerment campaigns for TB pa12 tients regarding local TB services; 

13 ‘‘(V) monitoring barriers to ac14 cessing TB services; and 

15 ‘‘(VI) increasing support for pa16 tient-led and community-led TB out17 reach efforts; 

18 ‘‘(ix) support for country-level, sus19 tainable accountability mechanisms and ca20 pacity to measure progress and ensure that 

21 commitments made by governments and 

22 relevant stakeholders are met; and 

23 ‘‘(x) support for the integration of TB 

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1 ties into primary health care, as appro2 priate. 

3 ‘‘(c) DEFINITIONS.—In this section: 

4 ‘‘(1) APPROPRIATE CONGRESSIONAL COMMIT5 TEES.—The term ‘appropriate congressional com6 mittees’ means the Committee on Foreign Relations 

7 of the Senate and the Committee on Foreign Affairs 

8 of the House of Representatives. 

9 ‘‘(2) END TB STRATEGY.—The term ‘End TB 

10 Strategy’ means the strategy to eliminate TB that 

11 was approved by the World Health Assembly in May 

12 2014, and is described in ‘The End TB Strategy: 

13 Global Strategy and Targets for Tuberculosis Pre14 vention, Care and Control After 2015’. 

15 ‘‘(3) GLOBAL ALLIANCE FOR TUBERCULOSIS

16 DRUG DEVELOPMENT.—The term ‘Global Alliance 

17 for Tuberculosis Drug Development’ means the pub18 lic-private partnership that bring together leaders in 

19 health, science, philanthropy, and private industry to 

20 devise new approaches to TB. 

21 ‘‘(4) GLOBAL TUBERCULOSIS DRUG FACIL22 ITY.—The term ‘Global Tuberculosis Drug Facility’ 

23 means the initiative of the Stop Tuberculosis Part24 nership to increase access to the most advanced, af25 fordable, quality-assured TB drugs and diagnostics. 


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1 ‘‘(5) MDR–TB.—The term ‘MDR–TB’ means 

2 multi-drug-resistant TB. 

3 ‘‘(6) STOP TUBERCULOSIS PARTNERSHIP.—The 

4 term ‘Stop Tuberculosis Partnership’ means the 

5 partnership of 1,600 organizations (including inter6 national and technical organizations, government 

7 programs, research and funding agencies, founda8 tions, nongovernmental organizations, civil society 

9 and community groups, and the private sector), do10 nors, including the United States, high TB burden 

11 countries, multilateral agencies, and nongovern12 mental and technical agencies, which is governed by 

13 the Stop TB Partnership Coordinating Board and 

14 hosted by a United Nations entity, committed to 

15 short- and long-term measures required to control 

16 and eventually eliminate TB as a public health prob17 lem in the world. 

18 ‘‘(7) XDR–TB.—The term ‘XDR–TB’ means 

19 extensively drug-resistant TB. 

20 ‘‘(d) AUTHORIZATION.—To carry out this section, the 

21 President is authorized, consistent with section 104(c), to 

22 furnish assistance, on such terms and conditions as the 

23 President may determine, for the prevention, treatment, 

24 control, and elimination of TB. 


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1 ‘‘(e) GOALS.—In consultation with the appropriate 

2 congressional committees, the President shall establish 

3 goals, based on the policy and indicators described in sub4 section (b), for— 

5 ‘‘(1) United States TB programs to detect, 

6 cure, and prevent all forms of TB globally for the 

7 period between 2023 and 2030 that are aligned with 

8 the End TB Strategy’s 2030 targets and the 

9 USAID’s Global Tuberculosis (TB) Strategy 2023– 

10 2030; and 

11 ‘‘(2) updating the National Action Plan for 

12 Combating Multidrug-Resistant Tuberculosis. 

13 ‘‘(f) COORDINATION.— 

14 ‘‘(1) IN GENERAL.—In carrying out this sec15 tion, the President shall coordinate with the World 

16 Health Organization, the Stop TB Partnership, the 

17 Global Fund to Fight AIDS, Tuberculosis, and Ma18 laria, and other organizations with respect to the de19 velopment and implementation of a comprehensive 

20 global TB response program. 

21 ‘‘(2) BILATERAL ASSISTANCE.—In providing bi22 lateral assistance under this section, the President, 

23 acting through the Administrator of the United 

24 States Agency for International Development, 

25 shall— 


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1 ‘‘(A) catalyze support for research and de2 velopment of new tools to prevent, diagnose, 

3 treat, and control TB worldwide, particularly to 

4 reduce the incidence of, and mortality from, all 

5 forms of drug-resistant TB; 

6 ‘‘(B) ensure United States programs and 

7 activities focus on finding individuals with ac8 tive TB disease and provide quality diagnosis 

9 and treatment, including through digital health 

10 solutions, and reaching those at high risk with 

11 preventive therapy; and 

12 ‘‘(C) ensure coordination among relevant 

13 United States Government agencies, including 

14 the Department of State, the Centers for Dis15 ease Control and Prevention, the National In16 stitutes of Health, the Biomedical Advanced 

17 Research and Development Authority, the Food 

18 and Drug Administration, the National Science 

19 Foundation, the Department of Defense 

20 (through its Congressionally Directed Medical 

21 Research Programs), and other relevant Fed22 eral departments and agencies that engage in 

23 international TB activities— 

24 ‘‘(i) to ensure accountability and 

25 transparency; 


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1 ‘‘(ii) to reduce duplication of efforts; 

2 and 

3 ‘‘(iii) to ensure appropriate integra4 tion and coordination of TB services into 

5 other United States-supported health pro6 grams. 

7 ‘‘(g) PRIORITY TO END TB STRATEGY.—In fur8 nishing assistance under subsection (d), the President 

9 shall prioritize— 

10 ‘‘(1) building and strengthening TB pro11 grams— 

12 ‘‘(A) to increase the diagnosis and treat13 ment of everyone who is sick with TB; and 

14 ‘‘(B) to ensure that such individuals have 

15 access to quality diagnosis and treatment; 

16 ‘‘(2) direct, high-quality integrated services for 

17 all forms of TB, as described by the World Health 

18 Organization, which call for the coordination of ac19 tive case finding, treatment of all forms of TB dis20 ease and infection, patient support, and TB preven21 tion; 

22 ‘‘(3) treating individuals co-infected with HIV 

23 and other co-morbidities, and other individuals with 

24 TB who may be at risk of stigma; 


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1 ‘‘(4) strengthening the capacity of health sys2 tems to detect, prevent, and treat TB, including 

3 MDR–TB and XDR–TB, as described in the latest 

4 international guidance related to TB; 

5 ‘‘(5) researching and developing innovative 

6 diagnostics, drug therapies, and vaccines, and pro7 gram-based research; 

8 ‘‘(6) support for the Stop Tuberculosis Partner9 ship’s Global Drug Facility, the Global Alliance for 

10 Tuberculosis Drug Development, and other organiza11 tions promoting the development of new products 

12 and drugs for TB; and 

13 ‘‘(7) ensuring that TB programs can serve as 

14 key platforms for supporting national respiratory 

15 pandemic response against existing and new infec16 tious respiratory disease. 

17 ‘‘(h) ASSISTANCE FOR THE WORLD HEALTH ORGA18 NIZATION AND THE STOP TUBERCULOSIS PARTNER19 SHIP.—In carrying out this section, the President, acting 

20 through the Administrator of the United States Agency 

21 for International Development, is authorized— 

22 ‘‘(1) to provide resources to the World Health 

23 Organization and the Stop Tuberculosis Partnership 

24 to improve the capacity of countries with high bur25 dens or rates of TB and other affected countries to 


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1 implement the End TB Strategy, the Stop TB Glob2 al Plan to End TB, their own national strategies 

3 and plans, other global efforts to control MDR–TB 

4 and XDR–TB; and 

5 ‘‘(2) to leverage the contributions of other do6 nors for the activities described in paragraph (1). 

7 ‘‘(i) ANNUAL REPORT ON TB ACTIVITIES.—Not later 

8 than December 15 of each year until the earlier of the 

9 date on which the goals specified in subsection (b)(2)(A) 

10 are met or the last day of 2030, the President shall submit 

11 an annual report to the appropriate congressional commit12 tees that describes United States foreign assistance to 

13 control TB and the impact of such efforts, including— 

14 ‘‘(1) the number of individuals with active TB 

15 disease that were diagnosed and treated, including 

16 the rate of treatment completion and the number re17 ceiving patient support; 

18 ‘‘(2) the number of persons with MDR–TB and 

19 XDR–TB that were diagnosed and treated, includ20 ing the rate of completion, in countries receiving 

21 United States bilateral foreign assistance for TB 

22 control programs; 

23 ‘‘(3) the number of people trained by the 

24 United States Government in TB surveillance and 

25 control; 


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1 ‘‘(4) the number of individuals with active TB 

2 disease identified as a result of engagement with the 

3 private sector and other nongovernmental partners 

4 in countries receiving United States bilateral foreign 

5 assistance for TB control programs; 

6 ‘‘(5) a description of the collaboration and co7 ordination of United States anti-TB efforts with the 

8 World Health Organization, the Stop TB Partner9 ship, the Global Fund to Fight AIDS, Tuberculosis 

10 and Malaria, and other major public and private en11 tities; 

12 ‘‘(6) a description of the collaboration and co13 ordination among the United States Agency for 

14 International Development and other United States 

15 departments and agencies, including the Centers for 

16 Disease Control and Prevention and the Office of 

17 the Global AIDS Coordinator, for the purposes of 

18 combating TB and, as appropriate, its integration 

19 into primary care; 

20 ‘‘(7) the constraints on implementation of pro21 grams posed by health workforce shortages, health 

22 system limitations, barriers to digital health imple23 mentation, other challenges to successful implemen24 tation, and strategies to address such constraints; 


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1 ‘‘(8) a breakdown of expenditures for patient 

2 services supporting TB diagnosis, treatment, and 

3 prevention, including procurement of drugs and 

4 other commodities, drug management, training in di5 agnosis and treatment, health systems strengthening 

6 that directly impacts the provision of TB services, 

7 and research; and 

8 ‘‘(9) for each country, and when practicable, 

9 each project site receiving bilateral United States as10 sistance for the purpose of TB prevention, treat11 ment, and control— 

12 ‘‘(A) a description of progress toward the 

13 adoption and implementation of the most recent 

14 World Health Organization guidelines to im15 prove diagnosis, treatment, and prevention of 

16 TB for adults and children, disaggregated by 

17 sex, including the proportion of health facilities 

18 that have adopted the latest World Health Or19 ganization guidelines on strengthening moni20 toring systems and preventative, diagnostic, and 

21 therapeutic methods, including the use of rapid 

22 diagnostic tests and orally administered TB 

23 treatment regimens; 

24 ‘‘(B) the number of individuals screened 

25 for TB disease and the number evaluated for 


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1 TB infection using active case finding outside 

2 of health facilities; 

3 ‘‘(C) the number of individuals with active 

4 TB disease that were diagnosed and treated, in5 cluding the rate of treatment completion and 

6 the number receiving patient support; 

7 ‘‘(D) the number of adults and children, 

8 including people with HIV and close contacts, 

9 who are evaluated for TB infection, the number 

10 of adults and children started on treatment for 

11 TB infection, and the number of adults and 

12 children completing such treatment, 

13 disaggregated by sex and, as possible, income or 

14 wealth quintile; 

15 ‘‘(E) the establishment of effective TB in16 fection control in all relevant congregant set17 tings, including hospitals, clinics, and prisons; 

18 ‘‘(F) a description of progress in imple19 menting measures to reduce TB incidence, in20 cluding actions— 

21 ‘‘(i) to expand active case finding and 

22 contact tracing to reach vulnerable groups; 

23 and 


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1 ‘‘(ii) to expand TB preventive ther2 apy, engagement of the private sector, and 

3 diagnostic capacity; 

4 ‘‘(G) a description of progress to expand 

5 diagnosis, prevention, and treatment for all 

6 forms of TB, including in pregnant women, 

7 children, and individuals and groups at greater 

8 risk of TB, including migrants, prisoners, min9 ers, people exposed to silica, and people living 

10 with HIV/AIDS, disaggregated by sex; 

11 ‘‘(H) the rate of successful completion of 

12 TB treatment for adults and children, 

13 disaggregated by sex, and the number of indi14 viduals receiving support for treatment comple15 tion; 

16 ‘‘(I) the number of people, disaggregated 

17 by sex, receiving treatment for MDR–TB, the 

18 proportion of those treated with the latest regi19 mens endorsed by the World Health Organiza20 tion, factors impeding scale up of such treat21 ment, and a description of progress to expand 

22 community-based MDR–TB care; 

23 ‘‘(J) a description of TB commodity pro24 curement challenges, including shortages, 


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1 stockouts, or failed tenders for TB drugs or 

2 other commodities; 

3 ‘‘(K) the proportion of health facilities 

4 with specimen referral linkages to quality diag5 nostic networks, including established testing 

6 sites and reference labs, to ensure maximum ac7 cess and referral for second line drug resistance 

8 testing, and a description of the turnaround 

9 time for test results; 

10 ‘‘(L) the number of people trained by the 

11 United States Government to deliver high-qual12 ity TB diagnostic, preventative, monitoring, 

13 treatment, and care services; 

14 ‘‘(M) a description of how supported activi15 ties are coordinated with— 

16 ‘‘(i) country national TB plans and 

17 strategies; and 

18 ‘‘(ii) TB control efforts supported by 

19 the Global Fund to Fight AIDS, Tuber20 culosis, and Malaria, and other inter21 national assistance programs and funds, 

22 including in the areas of program develop23 ment and implementation; and 

24 ‘‘(N) for the first 3 years of the report re25 quired under this subsection, a description of 


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1 the progress in recovering from the negative im2 pact of COVID–19 on TB, including— 

3 ‘‘(i) whether there has been the devel4 opment and implementation of a com5 prehensive plan to recover TB activities 

6 from diversion of resources; 

7 ‘‘(ii) the continued use of bidirectional 

8 TB–COVID testing; and 

9 ‘‘(iii) progress on increased diagnosis 

10 and treatment of active TB. 

11 ‘‘(j) ANNUAL REPORT ON TB RESEARCH AND DE12 VELOPMENT.—The President, acting through the Admin13 istrator of the United States Agency for International De14 velopment, and in coordination with the National Insti15 tutes of Health, the Centers for Disease Control and Pre16 vention, the Biomedical Advanced Research and Develop17 ment Authority, the Food and Drug Administration, the 

18 National Science Foundation, and the Office of the Global 

19 AIDS Coordinator, shall submit to the appropriate con20 gressional committees until 2030 an annual report that— 

21 ‘‘(1) describes the current progress and chal22 lenges to the development of new tools for the pur23 pose of TB prevention, treatment, and control; 

24 ‘‘(2) identifies critical gaps and emerging prior25 ities for research and development, including for 


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1 rapid and point-of-care diagnostics, shortened treat2 ments and prevention methods, telehealth solutions 

3 for prevention and treatment, and vaccines; and 

4 ‘‘(3) describes research investments by type, 

5 funded entities, and level of investment. 

6 ‘‘(k) EVALUATION REPORT.—Not later than 3 years 

7 after the date of the enactment of the End Tuberculosis 

8 Now Act of 2023, and 5 years thereafter, the Comptroller 

9 General of the United States shall submit a report to the 

10 appropriate congressional committees that evaluates the 

11 performance and impact on TB prevention, diagnosis, 

12 treatment, and care efforts that are supported by United 

13 States bilateral assistance funding, including rec14 ommendations for improving such programs.’’. 

Æ 


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