II 

117TH CONGRESS 

1ST SESSION S. 2586 

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

for combating and eliminating tuberculosis, and for other purposes. 

IN THE SENATE OF THE UNITED STATES 

AUGUST 3, 2021 

Mr. BROWN (for himself, Mr. BLUMENTHAL, Ms. KLOBUCHAR, Mr. VAN HOLLEN, and Mr. MARKEY) introduced the following bill; which was read 

twice and referred to the Committee on Health, Education, Labor, and 

Pensions 

A BILL 

To amend the Public Health Service Act to enhance the 

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

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

3 SECTION 1. SHORT TITLE. 

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

5 Elimination Act of 2021’’. 

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

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

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


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1 (1) in subsection (a)— 

2 (A) by striking ‘‘The Secretary’’ and in3 serting the following: 

4 ‘‘(1) GRANTS.—The Secretary’’; and 

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

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

7 subsection, the Secretary may give priority to State 

8 health departments proposing to focus on the pre9 vention, control, and elimination of tuberculosis in 

10 high-risk populations, including foreign-born, home11 less, incarcerated, HIV-tuberculosis coinfected, and 

12 medically underserved populations.’’; 

13 (2) in subsection (b)— 

14 (A) in paragraph (3)— 

15 (i) in subparagraph (C), by redesig16 nating clauses (i) and (ii) as subclauses (I) 

17 and (II), respectively, and adjusting the 

18 margins accordingly; and 

19 (ii) by redesignating subparagraphs 

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

21 respectively, and adjusting the margins ac22 cordingly; 

23 (B) by redesignating paragraphs (1) 

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


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1 respectively, and adjusting the margins accord2 ingly; 

3 (C) in the matter preceding subparagraph 

4 (A), as so redesignated, by striking ‘‘With re5 spect to’’ and inserting the following: 

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

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

8 redesignated, and inserting the following: 

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

10 demonstrations, and studies in the health 

11 sciences that are related to— 

12 ‘‘(i) the development of new tools, in13 cluding vaccines and antimicrobial drugs, 

14 to prevent and treat tuberculosis; 

15 ‘‘(ii) novel therapeutics for special 

16 populations, including pediatric popu17 lations, immunosuppressed individuals, and 

18 pregnant women; 

19 ‘‘(iii) the development or testing of 

20 medical diagnostics to detect tuberculosis; 

21 ‘‘(iv) research to address the epidemi22 ology, mechanisms, and pathogenesis of tu23 berculosis; 

24 ‘‘(v) public health interventions to ad25 dress the prevention, treatment, and conVerDate Sep 11 2014 16:13 Aug 04, 2021 Jkt 019200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\S2586.IS S2586

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1 trol of tuberculosis, such as directly ob2 served therapy and non-pharmaceutical 

3 intervention; 

4 ‘‘(vi) methods to enhance detection 

5 and response to outbreaks of tuberculosis, 

6 including multidrug resistant tuberculosis; 

7 and 

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

9 (E) in subparagraph (C), as so redesig10 nated— 

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

12 redesignated, as clause (vii); 

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

14 by striking ‘‘; and’’ and inserting ‘‘;’’; and 

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

16 redesignated, the following: 

17 ‘‘(vi) the intensification of efforts to 

18 prevent, detect, and treat latent tuber19 culosis; and’’; 

20 (F) in subparagraph (D), as so redesig21 nated, by inserting before the period the fol22 lowing: ‘‘, including public awareness campaigns 

23 and development of educational, risk, and 

24 media communications, using materials in lan25 guages appropriate to target audiences’’; 


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1 (G) in subparagraph (F), as so redesig2 nated, by striking ‘‘paragraphs (1) through 

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

4 (D)’’; and 

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

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

7 described in paragraph (1), the Secretary— 

8 ‘‘(A) is encouraged to give priority to pro9 grammatically relevant research so that new 

10 tools can be utilized in public health practice; 

11 and 

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

13 Advanced Research and Development Authority 

14 in identifying novel candidates to utilize in the 

15 efforts under this subsection to prevent, diag16 nose, and control tuberculosis.’’; 

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

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

19 (4) by inserting after subsection (b) the fol20 lowing— 

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

22 SERVICES FOR PREVENTION, DIAGNOSIS, AND TREAT23 MENT.— 

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

25 the Administrator of the Health Resources and ServVerDate Sep 11 2014 16:13 Aug 04, 2021 Jkt 019200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6201 E:\BILLS\S2586.IS S2586

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1 ices Administration, may award grants to State and 

2 local governments, territories, Indian Tribes, Tribal 

3 organizations, urban Indian health organizations, 

4 health service providers to Indian Tribes, Native Ha5 waiian health organizations, community health cen6 ters, and Federally qualified health centers for co7 ordinating the programs and services of such entities 

8 to ensure timely and appropriate prevention, risk9 based screening, diagnosis, and treatment of latent 

10 and active tuberculosis. 

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

12 ‘Federally qualified health center’ has the meaning 

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

14 Security Act.’’; 

15 (5) in subsections (d), (e), and (f), as so redes16 ignated, by striking ‘‘(a) or (b)’’ each place it ap17 pears and inserting ‘‘(a), (b), or (c)’’; 

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

19 adding at the end the following: 

20 ‘‘(C) REPORT TO CONGRESS.—The Sec21 retary is encouraged to make the reports under 

22 subparagraph (A), or other publications rel23 evant to domestic tuberculosis surveillance, pub24 licly available on the internet website of the 

25 Centers for Disease Control and Prevention and 


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1 to disseminate such information to stake2 holders.’’; 

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

4 (A) in paragraph (1)— 

5 (i) by striking ‘‘research into new 

6 tools under subsection (b)(2)’’ and insert7 ing ‘‘the research, investigations, experi8 ments, demonstrations, and studies in 

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

10 and 

11 (ii) by inserting ‘‘ensuring access to 

12 the products developed as a result of such 

13 research, investigations, experiments, dem14 onstrations, and studies and’’ after ‘‘advice 

15 regarding’’; and 

16 (B) in paragraph (3)— 

17 (i) by redesignating subparagraphs 

18 (D) and (E) as subparagraphs (E) and 

19 (F), respectively; and 

20 (ii) by inserting after subparagraph 

21 (C) the following: 

22 ‘‘(D) members of the Biomedical Advanced 

23 Research and Development Authority;’’; and 

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

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


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

2 fiscal year 2022, $195,700,000 for fiscal year 2023, 

3 $225,000,000 for fiscal year 2024, $236,250,000 for 

4 fiscal year 2025, $248,062,500 for fiscal year 2026, 

5 and $260,465,625 for fiscal year 2027.’’. 

6 (b) NIH TUBERCULOSIS ACTIVITIES.—Section 

7 424C(b) of the Public Health Service Act (42 U.S.C. 

8 285b–7c(b)) is amended by striking paragraph (1) and in9 serting the following: 

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

11 research on tuberculosis, including with respect to— 

12 ‘‘(A) drug-resistant tuberculosis; 

13 ‘‘(B) infection with tuberculosis and la14 tency and progression of tuberculosis; and 

15 ‘‘(C) pediatric tuberculosis;’’. 

16 SEC. 3. GAO STUDIES. 

17 (a) TUBERCULOSIS PREVENTION AND ELIMINATION

18 STUDY.—Not later than 2 years after the date of enact19 ment of this Act, the Comptroller General of the United 

20 States shall issue a report on the coordination of efforts 

21 in the United States to— 

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

23 and 

24 (2) implement the activities under section 317E 

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


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

2 Plan for Combating Multidrug-Resistant Tuber3 culosis, issued in December 2015. 

4 (b) STUDY ON TUBERCULOSIS ACTIVITIES.—Not 

5 later than 6 months after the date of enactment of this 

6 Act, the Comptroller General of the United States shall 

7 issue to the Committee on Health, Education, Labor, and 

8 Pensions of the Senate and the Committee on Energy and 

9 Commerce of the House of Representatives a report on 

10 the coordination of activities between the Food and Drug 

11 Administration and the Centers for Disease Control and 

12 Prevention with respect to— 

13 (1) shortages of critical tuberculosis drugs in 

14 the United States; 

15 (2) efforts to increase the availability of pedi16 atric tuberculosis drug formulations in the United 

17 States; 

18 (3) mitigating the cost of tuberculosis drugs for 

19 States, including efforts to ensure States have timely 

20 access to treatments for individuals with tuber21 culosis; and 

22 (4) consideration for the introduction in the 

23 United States of pediatric tuberculosis drug formu24 lations that are available in foreign countries. 

Æ 


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