II 

117TH CONGRESS 

1ST SESSION S. 3386 

To prevent, treat, and cure tuberculosis globally. 

IN THE SENATE OF THE UNITED STATES 

DECEMBER 14, 2021 

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 2021’’. 

6 SEC. 2. FINDINGS. 

7 Congress makes the following findings: 

8 (1) More than 25 years after the World Health 

9 Organization declared Tuberculosis (referred to in 

10 this Act as ‘‘TB’’) a public health emergency and 

11 called on countries to make scaling up tuberculosis 

12 control a priority, TB remains a deadly health 


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1 threat despite the fact that TB is a preventable, 

2 treatable, and curable disease. 

3 (2) In 2019 alone, an estimated 10,000,000 

4 people became ill with TB, 10 percent of whom were 

5 children, and 1,400,000 of whom died. In order to 

6 achieve by 2035 the goals of the Political Declara7 tion of the High-Level Meeting of the General As8 sembly on the Fight Against Tuberculosis, adopted 

9 by the United Nations General Assembly October 

10 10, 2018, and of the World Health Organization 

11 End TB Strategy, adopted by the World Health As12 sembly in 2014, new tools must be developed and 

13 made available. 

(3) Over 1 14 ⁄3 of people who become ill with TB 

15 may be undiagnosed or misdiagnosed, resulting in 

16 unnecessary illness, communicable infections, and in17 creased 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, with detection 

22 dropping by 50 percent and an estimated 1,000,000 

23 fewer people will be diagnosed and enrolled on TB 

24 treatment. 


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1 (5) In May 2020, a modeling study conducted 

2 by the Stop Tuberculosis Partnership (referred to in 

3 this Act as the ‘‘Stop TB Partnership’’) in collabo4 ration with the United States Agency for Inter5 national Development (referred to in this Act as 

6 ‘‘USAID’’) and partners estimated that a 3-month 

7 global lockdown followed by a protracted 10-month 

8 restoration could lead to an additional 6,300,000 

9 cases of TB between 2020 and 2025 and an addi10 tional 1,400,000 TB deaths during this period, caus11 ing a setback of at least 5 to 8 years in the fight 

12 against TB. 

13 (6) Findings released by the Stop TB Partner14 ship on March 18, 2021, found that TB diagnosis 

15 and enrolment on treatment in 2020 declined by an 

16 estimated total of 1,000,000 cases in 9 countries 

17 that collectively represent 60 percent of the global 

18 TB caseload, pushing the TB response back to 2008 

19 levels in terms of people diagnosed and treated. 

20 (7) Failure to properly diagnose and treat TB 

21 can lead to death and can exacerbate antimicrobial 

22 resistance, a key contributor to rising cases of multi23 drug-resistant tuberculosis, and extensively drug-re24 sistant tuberculosis, and increasing the probability of 


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1 the introduction of resistant TB into new geographic 

2 areas. 

3 (8) TB programs have played a central role in 

4 responding to COVID–19, including through 

5 leveraging the expertise of medical staff with exper6 tise in TB and lung diseases, the repurposing of TB 

7 hospitals, and the use of the TB rapid molecular 

8 testing platforms and X-Ray equipment for multiple 

9 purposes, including COVID–19. 

10 (9) With sufficient resourcing, TB program ex11 pertise, infection control, laboratory capacity, active 

12 case finding and contact investigation, can serve as 

13 a platform for respiratory pandemic response 

14 against existing and new infectious respiratory dis15 ease without such a response necessitating the dis16 ruption of ongoing TB programs and activities. 

(10) Globally, only about 1 17 ⁄2 of the 

18 $13,000,000,000 required annually outlined in the 

19 Stop TB Partnership’s Global Plan to End TB for 

20 tuberculosis prevention, diagnosis, and treatment is 

21 currently available. 

22 (11) An estimated additional $3,500,000,000 

23 will be needed during 2021 for TB programs in 

24 countries eligible for Global Fund for AIDS, Tuber25 culosis, and Malaria programming to recover from 


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1 the negative impacts of COVID–19, with a total an2 nual gap of at least $8,000,000,000 for TB diag3 nosis, prevention, and treatment in such countries. 

4 (12) On September 26, 2018, the United Na5 tions convened the first High-Level Meeting of the 

6 General Assembly on the Fight Against Tuber7 culosis, at which 120 countries— 

8 (A) signed a Political Declaration to accel9 erate progress against TB, including commit10 ments to increase funding for TB control and 

11 research and development programs, and ambi12 tious goals to successfully treat 40,000,000 peo13 ple with tuberculosis and prevent at least 

14 30,000,000 from becoming ill with TB between 

15 2018 and 2022; and 

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

17 all countries, and pledge[d] to provide leader18 ship and to work together to accelerate our na19 tional and global collective actions, investments 

20 and innovations urgently to fight this prevent21 able and treatable disease,’’ as reflected in 

22 United Nations General Assembly Resolution A/ 

23 RES/73/3. 

24 (13) The United States Government continues 

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1 opment, contributing 44 percent of the total 

2 $901,000,000 in global funding in 2019, and can 

3 catalyze more investments from other countries. 

4 (14) Working with governments and partners 

5 around the world, the TB efforts by USAID have 

6 saved 60,000,000 lives, demonstrating the effective7 ness of United States programs and activities. 

8 (15) On September 26, 2018, the USAID Ad9 ministrator announced a new performance-based 

10 Global Accelerator to End TB, aimed at catalyzing 

11 investments to meet the target set by the United 

12 Nations High-Level Meeting on tuberculosis of treat13 ing 40,000,000 people with the disease by 2022, fur14 ther demonstrating the critical role that United 

15 States leadership and assistance plays in the fight to 

16 eliminate TB. 

17 (16) It is essential to ensure that efforts among 

18 United States Government agencies, partner nations, 

19 international organizations, nongovernmental organi20 zations, the private sector, and other actors are com21 plementary and not duplicative in order to achieve 

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


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1 SEC. 3. UNITED STATES GOVERNMENT ACTIONS TO END 

2 TUBERCULOSIS. 

3 Section 104B of the Foreign Assistance Act of 1961 

4 (22 U.S.C. 2151b–3) is amended to read as follows: 

5 ‘‘SECTION 104B. ASSISTANCE TO COMBAT TUBERCULOSIS. 

6 ‘‘(a) FINDINGS.—Congress makes the following find7 ings: 

8 ‘‘(1) Congress recognizes the continuing chal9 lenge of the international spread of tuberculosis, and 

10 the deadly impact of the continued existence of TB. 

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

12 to effectively diagnose, prevent, and treat tuber13 culosis. 

14 ‘‘(3) Effectively resourced tuberculosis pro15 grams can serve as a critical platform for respiratory 

16 pandemic response against existing and new infec17 tious respiratory disease. 

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

19 assistance program of the United States to help end the 

20 global tuberculosis pandemic through actions to support 

21 the diagnosis and treatment of all adults and children with 

22 all forms of tuberculosis, and to prevent new tuberculosis 

23 infections in adults and children. In all countries in which 

24 the United States Government has established develop25 ment programs, particularly in countries with the highest 


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1 burden of tuberculosis and other countries with high rates 

2 of tuberculosis, it is the policy of the United States— 

3 ‘‘(1) to support the objectives of the World 

4 Health Organization End TB Strategy, including 

5 goals— 

6 ‘‘(A) to reduce by 95 percent tuberculosis 

7 deaths by 2035; 

8 ‘‘(B) to reduce by 90 percent the tuber9 culosis incidence rate by 2035; and 

10 ‘‘(C) to reduce by 100 percent the number 

11 of families facing catastrophic health costs due 

12 to tuberculosis by 2035; 

13 ‘‘(2) to support the Stop TB Partnership’s 

14 Global Plan to End TB 2018–2022, and any follow 

15 up plan, including support for— 

16 ‘‘(A) developing and using innovative new 

17 technologies and therapies to increase active 

18 case finding to rapidly diagnose and treat chil19 dren and adults with all forms of tuberculosis, 

20 alleviate suffering, and ensure tuberculosis 

21 treatment completion; 

22 ‘‘(B) providing diagnosis and treatment 

23 with the goal of successfully treating 

24 40,000,000 people with tuberculosis by 2022, 

25 including 3,500,000 children, and 1,500,000 


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1 people with drug-resistant tuberculosis in sup2 port of the target set by the Political Declara3 tion of the High-Level Meeting of the General 

4 Assembly on the Fight Against Tuberculosis; 

5 ‘‘(C) diagnosing and treating latent tuber6 culosis infection, in support of the global goal 

7 of providing preventive therapy to at least 

8 30,000,000 people, including 4,000,000 children 

9 under 5 years of age, 20,000,000 household 

10 contacts of people affected by tuberculosis, and 

11 6,000,000 people living with HIV, by 2022; 

12 ‘‘(D) ensuring high quality tuberculosis 

13 care by closing gaps in care cascades, imple14 menting continuous quality improvement at all 

15 levels of care, and providing patient support; 

16 and 

17 ‘‘(E) sustainably procuring tuberculosis 

18 commodities to avoid interruptions in supply, 

19 the procurement of commodities of unknown 

20 quality, or payment of excessive commodity 

21 costs in countries impacted by tuberculosis; and 

22 ‘‘(3) to ensure that United States funding sup23 ports activities that simultaneously emphasize— 

24 ‘‘(A) the development of comprehensive 

25 person-centered programs, including diagnosis, 


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1 treatment, and prevention strategies to ensure 

2 that— 

3 ‘‘(i) all people sick with tuberculosis 

4 receive quality diagnosis and treatment 

5 through active case finding; and 

6 ‘‘(ii) people at high risk for tuber7 culosis infection are found and treated 

8 with preventive therapies in a timely man9 ner; 

10 ‘‘(B) robust tuberculosis infection control 

11 practices are implemented in all congregate set12 tings, including hospitals and prisons; 

13 ‘‘(C) the deployment of diagnostic and 

14 treatment capacity— 

15 ‘‘(i) in areas with the highest tuber16 culosis burdens; and 

17 ‘‘(ii) for highly at-risk and impover18 ished populations, including patient sup19 port; 

20 ‘‘(D) program monitoring and evaluation 

21 based on critical tuberculosis indicators, includ22 ing indicators relating to infection control, the 

23 numbers of patients accessing tuberculosis 

24 treatment, along with patient support services, 

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1 cluding all close contacts, and treatment out2 comes for all forms of tuberculosis; 

3 ‘‘(E) training and engagement of health 

4 care workers on the use of new diagnostic tools 

5 and therapies as they become available, and in6 creased support for training frontline health 

7 care workers to support expanded tuberculosis 

8 active case finding, contact tracing and patient 

9 support; 

10 ‘‘(F) coordination with domestic agencies 

11 and organizations on an aggressive research 

12 agenda to develop vaccines as well as new tools 

13 to diagnose, treat, and prevent tuberculosis 

14 globally; 

15 ‘‘(G) linkages with the private sector on— 

16 ‘‘(i) research and development of a 

17 vaccine, and on new tools for diagnosis and 

18 treatment of tuberculosis; 

19 ‘‘(ii) improving current tools for diag20 nosis and treatment of tuberculosis; and 

21 ‘‘(iii) training healthcare professionals 

22 on use of the newest and most effective di23 agnostic and therapeutic tools; 


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1 ‘‘(H) the reduction of barriers to care, in2 cluding stigma and treatment and diagnosis 

3 costs, through— 

4 ‘‘(i) training for health workers; 

5 ‘‘(ii) sensitizing of policy makers; 

6 ‘‘(iii) requirements for access and af7 fordability provisions in all grants and 

8 funding agreements; 

9 ‘‘(iv) education and empowerment 

10 campaigns for tuberculosis patients regard11 ing local tuberculosis services; 

12 ‘‘(v) monitoring barriers to accessing 

13 tuberculosis services; and 

14 ‘‘(vi) increased support for patient-led 

15 and community-led tuberculosis outreach 

16 efforts; and 

17 ‘‘(I) support for country-level, sustainable 

18 accountability mechanisms and capacity to 

19 measure progress and ensure that commitments 

20 made by governments and relevant stakeholders 

21 are met. 

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 tuber5 culosis that was approved by the World Health As6 sembly in May 2014, and is described in The End 

7 TB Strategy: Global strategy and targets for tuber8 culosis prevention, 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 tuberculosis. 

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 tuberculosis drugs and 

20 diagnostics. 

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

22 multi-drug-resistant tuberculosis. 

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

24 term ‘Stop Tuberculosis Partnership’ means the 

25 partnership of the United Nations Office for Project 


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1 Services, donors including the United States, high 

2 tuberculosis burden countries, multilateral agencies, 

3 and nongovernmental and technical agencies com4 mitted to short- and long-term measures required to 

5 control and eventually eliminate tuberculosis as a 

6 public health problem in the world. 

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

8 extensively drug-resistant tuberculosis. 

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

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

11 furnish assistance, on such terms and conditions as the 

12 President may determine, for the prevention, treatment, 

13 control, and elimination of tuberculosis. 

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

15 congressional committees, the President shall establish 

16 goals, based on the policy and indicators described in sub17 section (b), for United States tuberculosis programs to de18 tect, cure and prevent all forms of tuberculosis globally 

19 for the period between 2023 and 2030 that is aligned with 

20 the End TB Strategy’s 2030 targets, by updating the 

21 United States Government Tuberculosis Strategy (2015– 

22 2019) and the National Action Plan for Combating 

23 Multidrug-Resistant Tuberculosis. 

24 ‘‘(f) COORDINATION.— 


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1 ‘‘(1) IN GENERAL.—In carrying out this sec2 tion, the President shall coordinate with the World 

3 Health Organization, the Stop TB Partnership, the 

4 Global Fund to Fight AIDS, Tuberculosis, and Ma5 laria, and other organizations with respect to the de6 velopment and implementation of a comprehensive 

7 global tuberculosis response program. 

8 ‘‘(2) BILATERAL ASSISTANCE.—In providing bi9 lateral assistance under this section, the President, 

10 acting through the Administrator of the United 

11 States Agency for International Development, 

12 shall— 

13 ‘‘(A) catalyze support for research and de14 velopment of new tools to prevent, diagnose, 

15 treat, and control tuberculosis worldwide, par16 ticularly to reduce the incidence of, and mor17 tality from, all forms of drug-resistant tuber18 culosis; 

19 ‘‘(B) ensure United States programs and 

20 activities aimed at reaching those infected with 

21 tuberculosis provide quality diagnosis and treat22 ment, and reach those at high risk with preven23 tive therapy; and 

24 ‘‘(C) ensure coordination among relevant 

25 United States Government agencies, including 


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1 the Centers for Disease Control and Prevention, 

2 the National Institutes of Health, the Bio3 medical Advanced Research and Development 

4 Authority, the Food and Drug Administration, 

5 the National Science Foundation, the Depart6 ment of Defense (through its Congressionally 

7 Directed Medical Research Program), and other 

8 Federal agencies that engage in international 

9 tuberculosis activities to ensure accountability 

10 and transparency, reduce duplication of efforts 

11 and ensure appropriate integration and coordi12 nation of tuberculosis services into other United 

13 States-supported health programs. 

14 ‘‘(g) PRIORITY TO END TB STRATEGY.—In fur15 nishing assistance under subsection (d), the President 

16 shall give priority to— 

17 ‘‘(1) building and strengthening tuberculosis 

18 programs to diagnose and treat all people sick with 

19 TB, and ensuring everyone who is sick with tuber20 culosis have access to quality diagnosis and treat21 ment; 

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

23 all forms of tuberculosis, as described by the World 

24 Health Organization, which call for the coordination 

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1 berculosis disease and infection, patient support, and 

2 tuberculosis prevention; 

3 ‘‘(3) individuals co-infected with HIV and other 

4 co-morbidities, and other individuals with tuber5 culosis who may be at risk of stigma; 

6 ‘‘(4) strengthening the capacity of health sys7 tems to detect, prevent, and treat tuberculosis, in8 cluding MDR–TB and XDR–TB, as described in the 

9 International Standards for Tuberculosis Care, and 

10 the latest international guidance related to tuber11 culosis; 

12 ‘‘(5) research and development of innovative 

13 diagnostics, drug therapies, and vaccines, and pro14 gram-based operational research; 

15 ‘‘(6) the Stop Tuberculosis Partnership’s Global 

16 Drug Facility, and the Global Alliance for Tuber17 culosis Drug Development, and other organizations 

18 promoting the development of new products and 

19 drugs for tuberculosis; and 

20 ‘‘(7) ensuring tuberculosis programs can serve 

21 as key platforms for supporting national respiratory 

22 pandemic response against existing and new infec23 tious respiratory disease. 

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1 SHIP.—In carrying out this section, the President, acting 

2 through the Administrator of the United States Agency 

3 for International Development, is authorized to provide in4 creased resources to the World Health Organization and 

5 the Stop Tuberculosis Partnership to improve the capacity 

6 of countries with high burdens or rates of tuberculosis and 

7 other affected countries to implement the End TB Strat8 egy, the Stop TB Global Plan to End TB, their own na9 tional strategies and plans, other global efforts to control 

10 MDR–TB and XDR–TB. 

11 ‘‘(i) ANNUAL REPORT ON TUBERCULOSIS ACTIVI12 TIES.—Not later than December 15 of each year until the 

13 goals specified in subsection (b)(1) are met, the President 

14 shall submit an annual report to the appropriate congres15 sional committees that describes United States foreign as16 sistance to control tuberculosis and the impact of such ef17 forts, including— 

18 ‘‘(1) the number of individuals with active tu19 berculosis disease that were diagnosed and treated, 

20 including the rate of treatment completion and the 

21 number receiving patient support; 

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

23 XDR–TB that were diagnosed and treated, includ24 ing the rate of completion, in countries receiving 


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1 United States bilateral foreign assistance for tuber2 culosis control programs; 

3 ‘‘(3) the numbers of people trained by the 

4 United States Government in tuberculosis surveil5 lance and control; 

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

7 disease identified as a result of engagement with the 

8 private sector and other nongovernmental partners 

9 in countries receiving United States bilateral foreign 

10 assistance for tuberculosis control programs; 

11 ‘‘(5) a description of the collaboration and co12 ordination of United States anti-tuberculosis efforts 

13 with the World Health Organization, the Stop TB 

14 Partnership, the Global Fund to Fight AIDS, Tu15 berculosis and Malaria, and other major public and 

16 private entities; 

17 ‘‘(6) a description of the collaboration and co18 ordination among the United States Agency for 

19 International Development and other United States 

20 agencies, including the Centers for Disease Control 

21 and Prevention and the Office of the Global AIDS 

22 Coordinator, for the purposes of combating tuber23 culosis; 

24 ‘‘(7) the constraints on implementation of pro25 grams posed by health workforce shortages, health 


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1 system limitations, other components of successful 

2 implementation, and strategies to address such con3 straints; 

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

5 services supporting TB diagnosis, treatment, and 

6 prevention, including procurement of drugs and 

7 other commodities, drug management, training in di8 agnosis and treatment, health systems strengthening 

9 that directly impacts provision of TB services, and 

10 research; and 

11 ‘‘(9) for each country receiving bilateral United 

12 States assistance for the purpose of tuberculosis pre13 vention, treatment, and control— 

14 ‘‘(A) a description of progress to adopt and 

15 implement the most recent World Health Orga16 nization guidelines to improve diagnosis, treat17 ment, and prevention of tuberculosis for adults 

18 and children, disaggregated by sex, including 

19 the proportion of health facilities that have 

20 adopted the latest World Health Organization 

21 guidelines on strengthening surveillance systems 

22 and preventative, diagnostic, and therapeutic 

23 methods, including the use of rapid diagnostic 

24 tests and orally administered tuberculosis treat25 ment regimens; 


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1 ‘‘(B) the number of adults and children re2 ceiving tuberculosis preventive therapy, includ3 ing people with HIV and all close contacts, 

4 disaggregated by sex and, as possible, income or 

5 wealth quintile, and the establishment of effec6 tive tuberculosis infection control in all relevant 

7 congregant settings, including hospitals, clinics, 

8 and prisons; 

9 ‘‘(C) a description of progress in imple10 menting measures to reduce tuberculosis inci11 dence, including actions— 

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

13 contact tracing to identify and reach vul14 nerable groups; and 

15 ‘‘(ii) to expand tuberculosis preventive 

16 therapy, engagement of the private sector, 

17 and diagnostic capacity; 

18 ‘‘(D) a description of progress to expand 

19 diagnosis, prevention, and treatment for all 

20 forms of tuberculosis, including in pregnant 

21 women, children, and other high-risk individuals 

22 and groups at greater risk of TB, including mi23 grants, prisoners, miners, people exposed to sili24 ca, and people living with HIV/AIDS, 

25 disaggregated by sex; 


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1 ‘‘(E) the rate of successful completion of 

2 tuberculosis treatment for adults and children, 

3 disaggregated by sex, and the number of indi4 viduals receiving support for treatment comple5 tion; 

6 ‘‘(F) the number of people, disaggregated 

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

8 proportion of those treated with the latest regi9 mens endorsed by the World Health Organiza10 tion, any factors impeding scale up of such 

11 treatment, and a description of progress to ex12 pand community-based MDR–TB care; 

13 ‘‘(G) a description of tuberculosis com14 modity procurement challenges, including short15 ages, stockouts, or failed tenders for tuber16 culosis drugs or other commodities; 

17 ‘‘(H) the proportion of health facilities 

18 with specimen referral linkages to GeneXpert 

19 testing sites, and to reference labs for second 

20 line drug resistance testing, and a description 

21 of the turnaround time for test results; 

22 ‘‘(I) the number of people trained by the 

23 United States Government to deliver high-qual24 ity tuberculosis surveillance, laboratory services, 

25 prevention, treatment, and care; 


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1 ‘‘(J) a description of how supported activi2 ties are coordinated with— 

3 ‘‘(i) country national TB plans and 

4 strategies; and 

5 ‘‘(ii) tuberculosis control efforts sup6 ported by the Global Fund to Fight AIDS, 

7 Tuberculosis, and Malaria, and other inter8 national assistance funds, including in the 

9 areas of program development and imple10 mentation; and 

11 ‘‘(K) for the first 3 years of the report re12 quired under this subsection, a section that de13 scribes the progress in recovering from the neg14 ative impact of COVID–19 on tuberculosis, in15 cluding whether there has been the development 

16 and implementation of a comprehensive plan to 

17 ensure tuberculosis activities recover from di18 version of resources, the continued use of 

19 bidirectional TB–COVID testing, and progress 

20 on increased diagnosis and treatment of active 

21 tuberculosis. 

22 ‘‘(j) ANNUAL REPORT ON TUBERCULOSIS RESEARCH

23 AND DEVELOPMENT.—The President, acting through the 

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1 tional Institutes of Health, the Centers for Disease Con2 trol and Prevention, the Biomedical Advanced Research 

3 and Development Authority, the Food and Drug Adminis4 tration, the National Science Foundation, and the Office 

5 of the Global AIDS Coordinator, shall submit an annual 

6 report to Congress that— 

7 ‘‘(1) describes current progress and challenges 

8 to the development of new tools for the purpose of 

9 tuberculosis prevention, treatment, and control; 

10 ‘‘(2) identifies critical gaps and emerging prior11 ities for research and development, including for 

12 rapid and point-of-care diagnostics, shortened treat13 ments and prevention methods, and vaccines; and 

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

15 funded entities, and level of investment. 

16 ‘‘(k) EVALUATION REPORT.—Not later than 2 years 

17 after the date of the enactment of the End Tuberculosis 

18 Now Act of 2021, and every 5 years thereafter until 2036, 

19 the Comptroller General of the United States shall submit 

20 a report to the appropriate congressional committees that 

21 evaluates the performance and impact on tuberculosis pre22 vention, diagnosis, treatment, and care efforts that are 

23 supported by United States bilateral assistance funding, 


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1 including recommendations for improving such pro2 grams.’’. 

Æ 


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