118TH CONGRESS 

2D SESSION S. 288 

AN ACT 

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, 
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1 SECTION 1. SHORT TITLE. 

2 This Act may be cited as the ‘‘End Tuberculosis Now 

3 Act of 2024’’. 

4 SEC. 2. UNITED STATES GOVERNMENT ASSISTANCE TO 

5 COMBAT TUBERCULOSIS. 

6 Section 104B of the Foreign Assistance Act of 1961 

7 (22 U.S.C. 2151b–3) is amended to read as follows: 

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

9 ‘‘(a) FINDINGS.—Congress makes the following find10 ings: 

11 ‘‘(1) The international spread of tuberculosis 

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

13 impact of TB’s continued existence constitutes a 

14 continuing challenge. 

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

16 to effectively diagnose, prevent, and treat TB. 

17 ‘‘(3) Effectively resourced TB programs can 

18 serve as a critical platform for preventing and re19 sponding to future infectious respiratory disease 

20 pandemics. 

21 ‘‘(b) POLICY.— 

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

23 the foreign assistance program of the United States 

24 to help end the TB public health emergency through 

25 accelerated actions— 
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1 ‘‘(A) to support the diagnosis and treat2 ment of all adults and children with all forms 

3 of TB; and 

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

5 occurring. 

6 ‘‘(2) SUPPORT FOR GLOBAL PLANS AND OBJEC7 TIVES.—In countries in which the United States 

8 Government has established foreign assistance pro9 grams under this Act, particularly in countries with 

10 the highest burden of TB and other countries with 

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

12 the policy of the United States— 

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

14 Health Organization End TB Strategy, includ15 ing its goals— 

16 ‘‘(i) to reduce TB deaths by 95 per17 cent by 2035; 

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

19 by 90 percent by 2035; and 

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

21 facing catastrophic health costs due to TB 

22 by 100 percent by 2035; 

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

24 Global Plan to End TB 2023–2030, including 

25 by providing support for— 
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1 ‘‘(i) developing and using innovative 

2 new technologies and therapies to increase 

3 active case finding and rapidly diagnose 

4 and treat children and adults with all 

5 forms of TB, alleviate suffering, and en6 sure TB treatment completion; 

7 ‘‘(ii) expanding diagnosis and treat8 ment in line with the goals established by 

9 the Political Declaration of the High-Level 

10 Meeting of the General Assembly on the 

11 Fight Against Tuberculosis, including— 

12 ‘‘(I) successfully treating 

13 40,000,000 people with active TB by 

14 2023, including 3,500,000 children, 

15 and 1,500,000 people with drug-re16 sistant TB; and 

17 ‘‘(II) diagnosing and treating la18 tent tuberculosis infection, in support 

19 of the global goal of providing preven20 tive therapy to at least 30,000,000 

21 people by 2023, including 4,000,000 

22 children younger than 5 years of age, 

23 20,000,000 household contacts of peo24 ple affected by TB, and 6,000,000 

25 people living with HIV; 
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1 ‘‘(iii) ensuring high-quality TB care 

2 by closing gaps in care cascades, imple3 menting continuous quality improvement 

4 at all levels of care, and providing related 

5 patient support; and 

6 ‘‘(iv) sustainable procurements of TB 

7 commodities to avoid interruptions in sup8 ply, the procurement of commodities of un9 known quality, or payment of excessive 

10 commodity costs in countries impacted by 

11 TB; and 

12 ‘‘(C) to ensure, to the greatest extent prac13 ticable, that United States funding supports ac14 tivities that simultaneously emphasize— 

15 ‘‘(i) the development of comprehensive 

16 person-centered programs, including diag17 nosis, treatment, and prevention strategies 

18 to ensure that— 

19 ‘‘(I) all people sick with TB re20 ceive quality diagnosis and treatment 

21 through active case finding; and 

22 ‘‘(II) people at high risk for TB 

23 infection are found and treated with 

24 preventive therapies in a timely man25 ner; 
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1 ‘‘(ii) robust TB infection control prac2 tices are implemented in all congregate set3 tings, including hospitals and prisons; 

4 ‘‘(iii) the deployment of diagnostic 

5 and treatment capacity— 

6 ‘‘(I) in areas with the highest TB 

7 burdens; and 

8 ‘‘(II) for highly at-risk and im9 poverished populations, including pa10 tient support services; 

11 ‘‘(iv) program monitoring and evalua12 tion based on critical TB indicators, in13 cluding indicators relating to infection con14 trol, the numbers of patients accessing TB 

15 treatment and patient support services, 

16 and preventative therapy for those at risk, 

17 including all close contacts, and treatment 

18 outcomes for all forms of TB; 

19 ‘‘(v) training and engagement of 

20 health care workers on the use of new di21 agnostic tools and therapies as they be22 come available, and increased support for 

23 training frontline health care workers to 

24 support expanded TB active case finding, 
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1 contact tracing, and patient support serv2 ices; 

3 ‘‘(vi) coordination with domestic agen4 cies and organizations to support an ag5 gressive research agenda to develop vac6 cines as well as new tools to diagnose, 

7 treat, and prevent TB globally; 

8 ‘‘(vii) linkages with the private sector 

9 on— 

10 ‘‘(I) research and development of 

11 a vaccine, and on new tools for diag12 nosis and treatment of TB; 

13 ‘‘(II) improving current tools for 

14 diagnosis and treatment of TB, in15 cluding telehealth solutions for pre16 vention and treatment; and 

17 ‘‘(III) training healthcare profes18 sionals on use of the newest and most 

19 effective diagnostic and therapeutic 

20 tools; 

21 ‘‘(viii) the reduction of barriers to 

22 care, including stigma and treatment and 

23 diagnosis costs, including through— 

24 ‘‘(I) training health workers; 

25 ‘‘(II) sensitizing policy makers; 
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1 ‘‘(III) requiring that all relevant 

2 grants and funding agreements in3 clude access and affordability provi4 sions; 

5 ‘‘(IV) supporting education and 

6 empowerment campaigns for TB pa7 tients regarding local TB services; 

8 ‘‘(V) monitoring barriers to ac9 cessing TB services; and 

10 ‘‘(VI) increasing support for pa11 tient-led and community-led TB out12 reach efforts; 

13 ‘‘(ix) support for country-level, sus14 tainable accountability mechanisms and ca15 pacity to measure progress and ensure that 

16 commitments made by governments and 

17 relevant stakeholders are met; and 

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

19 diagnosis, treatment, and prevention activi20 ties into primary health care, as appro21 priate. 

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

23 ‘‘(1) APPROPRIATE CONGRESSIONAL COMMIT24 TEES.—The term ‘appropriate congressional com25 mittees’ means the Committee on Foreign Relations 
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1 of the Senate and the Committee on Foreign Affairs 

2 of the House of Representatives. 

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

4 Strategy’ means the strategy to eliminate TB that 

5 was approved by the World Health Assembly in May 

6 2014, and is described in ‘The End TB Strategy: 

7 Global Strategy and Targets for Tuberculosis Pre8 vention, Care and Control After 2015’. 

9 ‘‘(3) GLOBAL ALLIANCE FOR TUBERCULOSIS

10 DRUG DEVELOPMENT.—The term ‘Global Alliance 

11 for Tuberculosis Drug Development’ means the pub12 lic-private partnership that bring together leaders in 

13 health, science, philanthropy, and private industry to 

14 devise new approaches to TB. 

15 ‘‘(4) GLOBAL TUBERCULOSIS DRUG FACIL16 ITY.—The term ‘Global Tuberculosis Drug Facility’ 

17 means the initiative of the Stop Tuberculosis Part18 nership to increase access to the most advanced, af19 fordable, quality-assured TB drugs and diagnostics. 

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

21 multi-drug-resistant TB. 

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

23 term ‘Stop Tuberculosis Partnership’ means the 

24 partnership of 1,600 organizations (including inter25 national and technical organizations, government 
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1 programs, research and funding agencies, founda2 tions, nongovernmental organizations, civil society 

3 and community groups, and the private sector), do4 nors, including the United States, high TB burden 

5 countries, multilateral agencies, and nongovern6 mental and technical agencies, which is governed by 

7 the Stop TB Partnership Coordinating Board and 

8 hosted by a United Nations entity, committed to 

9 short- and long-term measures required to control 

10 and eventually eliminate TB as a public health prob11 lem in the world. 

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

13 extensively drug-resistant TB. 

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

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

16 furnish assistance, on such terms and conditions as the 

17 President may determine, for the prevention, treatment, 

18 control, and elimination of TB. 

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

20 congressional committees, the President shall establish 

21 goals, based on the policy and indicators described in sub22 section (b), for— 

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

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

25 period between 2023 and 2030 that are aligned with 
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1 the End TB Strategy’s 2030 targets and the 

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

3 2030; and 

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

5 Combating Multidrug-Resistant Tuberculosis. 

6 ‘‘(f) COORDINATION.— 

7 ‘‘(1) IN GENERAL.—In carrying out this sec8 tion, the President shall coordinate with the World 

9 Health Organization, the Stop TB Partnership, the 

10 Global Fund to Fight AIDS, Tuberculosis, and Ma11 laria, and other organizations with respect to the de12 velopment and implementation of a comprehensive 

13 global TB response program. 

14 ‘‘(2) BILATERAL ASSISTANCE.—In providing bi15 lateral assistance under this section, the President, 

16 acting through the Administrator of the United 

17 States Agency for International Development, 

18 shall— 

19 ‘‘(A) catalyze support for research and de20 velopment of new tools to prevent, diagnose, 

21 treat, and control TB worldwide, particularly to 

22 reduce the incidence of, and mortality from, all 

23 forms of drug-resistant TB; 

24 ‘‘(B) ensure United States programs and 

25 activities focus on finding individuals with ac-
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1 tive TB disease and provide quality diagnosis 

2 and treatment, including through digital health 

3 solutions, and reaching those at high risk with 

4 preventive therapy; and 

5 ‘‘(C) ensure coordination among relevant 

6 United States Government agencies, including 

7 the Department of State, the Centers for Dis8 ease Control and Prevention, the National In9 stitutes of Health, the Biomedical Advanced 

10 Research and Development Authority, the Food 

11 and Drug Administration, the National Science 

12 Foundation, the Department of Defense 

13 (through its Congressionally Directed Medical 

14 Research Programs), and other relevant Fed15 eral departments and agencies that engage in 

16 international TB activities— 

17 ‘‘(i) to ensure accountability and 

18 transparency; 

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

20 and 

21 ‘‘(iii) to ensure appropriate integra22 tion and coordination of TB services into 

23 other United States-supported health pro24 grams. 
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1 ‘‘(g) PRIORITY TO END TB STRATEGY.—In fur2 nishing assistance under subsection (d), the President 

3 shall prioritize— 

4 ‘‘(1) building and strengthening TB pro5 grams— 

6 ‘‘(A) to increase the diagnosis and treat7 ment of everyone who is sick with TB; and 

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

9 access to quality diagnosis and treatment; 

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

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

12 Organization, which call for the coordination of ac13 tive case finding, treatment of all forms of TB dis14 ease and infection, patient support, and TB preven15 tion; 

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

17 and other co-morbidities, and other individuals with 

18 TB who may be at risk of stigma; 

19 ‘‘(4) strengthening the capacity of health sys20 tems to detect, prevent, and treat TB, including 

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

22 international guidance related to TB; 

23 ‘‘(5) researching and developing innovative 

24 diagnostics, drug therapies, and vaccines, and pro25 gram-based research; 
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1 ‘‘(6) support for the Stop Tuberculosis Partner2 ship’s Global Drug Facility, the Global Alliance for 

3 Tuberculosis Drug Development, and other organiza4 tions promoting the development of new products 

5 and drugs for TB; and 

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

7 key platforms for supporting national respiratory 

8 pandemic response against existing and new infec9 tious respiratory disease. 

10 ‘‘(h) ASSISTANCE FOR THE WORLD HEALTH ORGA11 NIZATION AND THE STOP TUBERCULOSIS PARTNER12 SHIP.—In carrying out this section, the President, acting 

13 through the Administrator of the United States Agency 

14 for International Development, is authorized— 

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

16 Organization and the Stop Tuberculosis Partnership 

17 to improve the capacity of countries with high bur18 dens or rates of TB and other affected countries to 

19 implement the End TB Strategy, the Stop TB Glob20 al Plan to End TB, their own national strategies 

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

22 and XDR–TB; and 

23 ‘‘(2) to leverage the contributions of other do24 nors for the activities described in paragraph (1). 
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1 ‘‘(i) ANNUAL REPORT ON TB ACTIVITIES.—Not later 

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

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

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

5 an annual report to the appropriate congressional commit6 tees that describes United States foreign assistance to 

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

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

9 disease that were diagnosed and treated, including 

10 the rate of treatment completion and the number re11 ceiving patient support; 

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

13 XDR–TB that were diagnosed and treated, includ14 ing the rate of completion, in countries receiving 

15 United States bilateral foreign assistance for TB 

16 control programs; 

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

18 United States Government in TB surveillance and 

19 control; 

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

21 disease identified as a result of engagement with the 

22 private sector and other nongovernmental partners 

23 in countries receiving United States bilateral foreign 

24 assistance for TB control programs; 
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1 ‘‘(5) a description of the collaboration and co2 ordination of United States anti-TB efforts with the 

3 World Health Organization, the Stop TB Partner4 ship, the Global Fund to Fight AIDS, Tuberculosis 

5 and Malaria, and other major public and private en6 tities; 

7 ‘‘(6) a description of the collaboration and co8 ordination among the United States Agency for 

9 International Development and other United States 

10 departments and agencies, including the Centers for 

11 Disease Control and Prevention and the Office of 

12 the Global AIDS Coordinator, for the purposes of 

13 combating TB and, as appropriate, its integration 

14 into primary care; 

15 ‘‘(7) the constraints on implementation of pro16 grams posed by health workforce shortages, health 

17 system limitations, barriers to digital health imple18 mentation, other challenges to successful implemen19 tation, and strategies to address such constraints; 

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

21 services supporting TB diagnosis, treatment, and 

22 prevention, including procurement of drugs and 

23 other commodities, drug management, training in di24 agnosis and treatment, health systems strengthening 
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1 that directly impacts the provision of TB services, 

2 and research; and 

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

4 each project site receiving bilateral United States as5 sistance for the purpose of TB prevention, treat6 ment, and control— 

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

8 adoption and implementation of the most recent 

9 World Health Organization guidelines to im10 prove diagnosis, treatment, and prevention of 

11 TB for adults and children, disaggregated by 

12 sex, including the proportion of health facilities 

13 that have adopted the latest World Health Or14 ganization guidelines on strengthening moni15 toring systems and preventative, diagnostic, and 

16 therapeutic methods, including the use of rapid 

17 diagnostic tests and orally administered TB 

18 treatment regimens; 

19 ‘‘(B) the number of individuals screened 

20 for TB disease and the number evaluated for 

21 TB infection using active case finding outside 

22 of health facilities; 

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

24 TB disease that were diagnosed and treated, in-
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1 cluding the rate of treatment completion and 

2 the number receiving patient support; 

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

4 including people with HIV and close contacts, 

5 who are evaluated for TB infection, the number 

6 of adults and children started on treatment for 

7 TB infection, and the number of adults and 

8 children completing such treatment, 

9 disaggregated by sex and, as possible, income or 

10 wealth quintile; 

11 ‘‘(E) the establishment of effective TB in12 fection control in all relevant congregant set13 tings, including hospitals, clinics, and prisons; 

14 ‘‘(F) a description of progress in imple15 menting measures to reduce TB incidence, in16 cluding actions— 

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

18 contact tracing to reach vulnerable groups; 

19 and 

20 ‘‘(ii) to expand TB preventive ther21 apy, engagement of the private sector, and 

22 diagnostic capacity; 

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

24 diagnosis, prevention, and treatment for all 

25 forms of TB, including in pregnant women, 
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1 children, and individuals and groups at greater 

2 risk of TB, including migrants, prisoners, min3 ers, people exposed to silica, and people living 

4 with HIV/AIDS, disaggregated by sex; 

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

6 TB treatment for adults and children, 

7 disaggregated by sex, and the number of indi8 viduals receiving support for treatment comple9 tion; 

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

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

12 proportion of those treated with the latest regi13 mens endorsed by the World Health Organiza14 tion, factors impeding scale up of such treat15 ment, and a description of progress to expand 

16 community-based MDR–TB care; 

17 ‘‘(J) a description of TB commodity pro18 curement challenges, including shortages, 

19 stockouts, or failed tenders for TB drugs or 

20 other commodities; 

21 ‘‘(K) the proportion of health facilities 

22 with specimen referral linkages to quality diag23 nostic networks, including established testing 

24 sites and reference labs, to ensure maximum ac25 cess and referral for second line drug resistance 
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1 testing, and a description of the turnaround 

2 time for test results; 

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

4 United States Government to deliver high-qual5 ity TB diagnostic, preventative, monitoring, 

6 treatment, and care services; 

7 ‘‘(M) a description of how supported activi8 ties are coordinated with— 

9 ‘‘(i) country national TB plans and 

10 strategies; and 

11 ‘‘(ii) TB control efforts supported by 

12 the Global Fund to Fight AIDS, Tuber13 culosis, and Malaria, and other inter14 national assistance programs and funds, 

15 including in the areas of program develop16 ment and implementation; and 

17 ‘‘(N) for the first 3 years of the report re18 quired under this subsection, a description of 

19 the progress in recovering from the negative im20 pact of COVID–19 on TB, including— 

21 ‘‘(i) whether there has been the devel22 opment and implementation of a com23 prehensive plan to recover TB activities 

24 from diversion of resources; 
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1 ‘‘(ii) the continued use of bidirectional 

2 TB–COVID testing; and 

3 ‘‘(iii) progress on increased diagnosis 

4 and treatment of active TB. 

5 ‘‘(j) ANNUAL REPORT ON TB RESEARCH AND DE6 VELOPMENT.—The President, acting through the Admin7 istrator of the United States Agency for International De8 velopment, and in coordination with the National Insti9 tutes of Health, the Centers for Disease Control and Pre10 vention, the Biomedical Advanced Research and Develop11 ment Authority, the Food and Drug Administration, the 

12 National Science Foundation, and the Office of the Global 

13 AIDS Coordinator, shall submit to the appropriate con14 gressional committees until 2030 an annual report that— 

15 ‘‘(1) describes the current progress and chal16 lenges to the development of new tools for the pur17 pose of TB prevention, treatment, and control; 

18 ‘‘(2) identifies critical gaps and emerging prior19 ities for research and development, including for 

20 rapid and point-of-care diagnostics, shortened treat21 ments and prevention methods, telehealth solutions 

22 for prevention and treatment, and vaccines; and 

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

24 funded entities, and level of investment. 
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1 ‘‘(k) EVALUATION REPORT.—Not later than 3 years 

2 after the date of the enactment of the End Tuberculosis 

3 Now Act of 2024, and 5 years thereafter, the Comptroller 

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

5 appropriate congressional committees that evaluates the 

6 performance and impact on TB prevention, diagnosis, 

7 treatment, and care efforts that are supported by United 

8 States bilateral assistance funding, including rec9 ommendations for improving such programs.’’. 

10 SEC. 3. SUNSET. 

11 The amendment made by section 2 shall cease to have 

12 any force or effect beginning on December 31, 2030. 

Passed the Senate September 19, 2024. 

Attest: 

Secretary. 

118TH CONGRESS 

2D SESSION S. 288 

AN ACT 

To prevent, treat, and cure tuberculosis globally.