```

[Congressional Bills 117th Congress]
[From the U.S. Government Publishing Office]
[S. 3386 Reported in Senate (RS)]

<DOC>

                                                       Calendar No. 601
117th CONGRESS
  2d Session
                                S. 3386

           To prevent, treat, and cure tuberculosis globally.

_______________________________________________________________________

                   IN THE SENATE OF THE UNITED STATES

                           December 14, 2021

Mr. Menendez (for himself, Mr. Young, Mr. Braun, Mr. Markey, Mr. Rubio, 
and Mr. Van Hollen) introduced the following bill; which was read twice 
           and referred to the Committee on Foreign Relations

                            December 7, 2022

              Reported by Mr. Menendez, with an amendment
 [Strike out all after the enacting clause and insert the part printed 
                               in italic]

_______________________________________________________________________

                                 A BILL

 
           To prevent, treat, and cure tuberculosis globally.

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

<DELETED>SECTION 1. SHORT TITLE.</DELETED>

<DELETED>    This Act may be cited as the ``End Tuberculosis Now Act of 
2021''.</DELETED>

<DELETED>SEC. 2. FINDINGS.</DELETED>

<DELETED>    Congress makes the following findings:</DELETED>
        <DELETED>    (1) More than 25 years after the World Health 
        Organization declared Tuberculosis (referred to in this Act as 
        ``TB'') a public health emergency and called on countries to 
        make scaling up tuberculosis control a priority, TB remains a 
        deadly health threat despite the fact that TB is a preventable, 
        treatable, and curable disease.</DELETED>
        <DELETED>    (2) In 2019 alone, an estimated 10,000,000 people 
        became ill with TB, 10 percent of whom were children, and 
        1,400,000 of whom died. In order to achieve by 2035 the goals 
        of the Political Declaration of the High-Level Meeting of the 
        General Assembly on the Fight Against Tuberculosis, adopted by 
        the United Nations General Assembly October 10, 2018, and of 
        the World Health Organization End TB Strategy, adopted by the 
        World Health Assembly in 2014, new tools must be developed and 
        made available.</DELETED>
        <DELETED>    (3) Over \1/3\ of people who become ill with TB 
        may be undiagnosed or misdiagnosed, resulting in unnecessary 
        illness, communicable infections, and increased 
        mortality.</DELETED>
        <DELETED>    (4) Since March 2020, the COVID-19 pandemic has 
        severely disrupted TB responses in low- and middle-income 
        countries, stalling and reversing years of progress made 
        against TB, with detection dropping by 50 percent and an 
        estimated 1,000,000 fewer people will be diagnosed and enrolled 
        on TB treatment.</DELETED>
        <DELETED>    (5) In May 2020, a modeling study conducted by the 
        Stop Tuberculosis Partnership (referred to in this Act as the 
        ``Stop TB Partnership'') in collaboration with the United 
        States Agency for International Development (referred to in 
        this Act as ``USAID'') and partners estimated that a 3-month 
        global lockdown followed by a protracted 10-month restoration 
        could lead to an additional 6,300,000 cases of TB between 2020 
        and 2025 and an additional 1,400,000 TB deaths during this 
        period, causing a setback of at least 5 to 8 years in the fight 
        against TB.</DELETED>
        <DELETED>    (6) Findings released by the Stop TB Partnership 
        on March 18, 2021, found that TB diagnosis and enrolment on 
        treatment in 2020 declined by an estimated total of 1,000,000 
        cases in 9 countries that collectively represent 60 percent of 
        the global TB caseload, pushing the TB response back to 2008 
        levels in terms of people diagnosed and treated.</DELETED>
        <DELETED>    (7) Failure to properly diagnose and treat TB can 
        lead to death and can exacerbate antimicrobial resistance, a 
        key contributor to rising cases of multi-drug-resistant 
        tuberculosis, and extensively drug-resistant tuberculosis, and 
        increasing the probability of the introduction of resistant TB 
        into new geographic areas.</DELETED>
        <DELETED>    (8) TB programs have played a central role in 
        responding to COVID-19, including through leveraging the 
        expertise of medical staff with expertise in TB and lung 
        diseases, the repurposing of TB hospitals, and the use of the 
        TB rapid molecular testing platforms and X-Ray equipment for 
        multiple purposes, including COVID-19.</DELETED>
        <DELETED>    (9) With sufficient resourcing, TB program 
        expertise, infection control, laboratory capacity, active case 
        finding and contact investigation, can serve as a platform for 
        respiratory pandemic response against existing and new 
        infectious respiratory disease without such a response 
        necessitating the disruption of ongoing TB programs and 
        activities.</DELETED>
        <DELETED>    (10) Globally, only about \1/2\ of the 
        $13,000,000,000 required annually outlined in the Stop TB 
        Partnership's Global Plan to End TB for tuberculosis 
        prevention, diagnosis, and treatment is currently 
        available.</DELETED>
        <DELETED>    (11) An estimated additional $3,500,000,000 will 
        be needed during 2021 for TB programs in countries eligible for 
        Global Fund for AIDS, Tuberculosis, and Malaria programming to 
        recover from the negative impacts of COVID-19, with a total 
        annual gap of at least $8,000,000,000 for TB diagnosis, 
        prevention, and treatment in such countries.</DELETED>
        <DELETED>    (12) On September 26, 2018, the United Nations 
        convened the first High-Level Meeting of the General Assembly 
        on the Fight Against Tuberculosis, at which 120 countries--
        </DELETED>
                <DELETED>    (A) signed a Political Declaration to 
                accelerate progress against TB, including commitments 
                to increase funding for TB control and research and 
                development programs, and ambitious goals to 
                successfully treat 40,000,000 people with tuberculosis 
                and prevent at least 30,000,000 from becoming ill with 
                TB between 2018 and 2022; and</DELETED>
                <DELETED>    (B) committed to ``ending the epidemic in 
                all countries, and pledge[d] to provide leadership and 
                to work together to accelerate our national and global 
                collective actions, investments and innovations 
                urgently to fight this preventable and treatable 
                disease,'' as reflected in United Nations General 
                Assembly Resolution A/RES/73/3.</DELETED>
        <DELETED>    (13) The United States Government continues to be 
        a lead funder of global TB research and development, 
        contributing 44 percent of the total $901,000,000 in global 
        funding in 2019, and can catalyze more investments from other 
        countries.</DELETED>
        <DELETED>    (14) Working with governments and partners around 
        the world, the TB efforts by USAID have saved 60,000,000 lives, 
        demonstrating the effectiveness of United States programs and 
        activities.</DELETED>
        <DELETED>    (15) On September 26, 2018, the USAID 
        Administrator announced a new performance-based Global 
        Accelerator to End TB, aimed at catalyzing investments to meet 
        the target set by the United Nations High-Level Meeting on 
        tuberculosis of treating 40,000,000 people with the disease by 
        2022, further demonstrating the critical role that United 
        States leadership and assistance plays in the fight to 
        eliminate TB.</DELETED>
        <DELETED>    (16) It is essential to ensure that efforts among 
        United States Government agencies, partner nations, 
        international organizations, nongovernmental organizations, the 
        private sector, and other actors are complementary and not 
        duplicative in order to achieve the goal of ending the TB 
        epidemic in all countries.</DELETED>

<DELETED>SEC. 3. UNITED STATES GOVERNMENT ACTIONS TO END 
              TUBERCULOSIS.</DELETED>

<DELETED>    Section 104B of the Foreign Assistance Act of 1961 (22 
U.S.C. 2151b-3) is amended to read as follows:</DELETED>

<DELETED>``SECTION 104B. ASSISTANCE TO COMBAT TUBERCULOSIS.</DELETED>

<DELETED>    ``(a) Findings.--Congress makes the following 
findings:</DELETED>
        <DELETED>    ``(1) Congress recognizes the continuing challenge 
        of the international spread of tuberculosis, and the deadly 
        impact of the continued existence of TB.</DELETED>
        <DELETED>    ``(2) Additional tools and resources are required 
        to effectively diagnose, prevent, and treat 
        tuberculosis.</DELETED>
        <DELETED>    ``(3) Effectively resourced tuberculosis programs 
        can serve as a critical platform for respiratory pandemic 
        response against existing and new infectious respiratory 
        disease.</DELETED>
<DELETED>    ``(b) Policy.--It is a major objective of the foreign 
assistance program of the United States to help end the global 
tuberculosis pandemic through actions to support the diagnosis and 
treatment of all adults and children with all forms of tuberculosis, 
and to prevent new tuberculosis infections in adults and children. In 
all countries in which the United States Government has established 
development programs, particularly in countries with the highest burden 
of tuberculosis and other countries with high rates of tuberculosis, it 
is the policy of the United States--</DELETED>
        <DELETED>    ``(1) to support the objectives of the World 
        Health Organization End TB Strategy, including goals--
        </DELETED>
                <DELETED>    ``(A) to reduce by 95 percent tuberculosis 
                deaths by 2035;</DELETED>
                <DELETED>    ``(B) to reduce by 90 percent the 
                tuberculosis incidence rate by 2035; and</DELETED>
                <DELETED>    ``(C) to reduce by 100 percent the number 
                of families facing catastrophic health costs due to 
                tuberculosis by 2035;</DELETED>
        <DELETED>    ``(2) to support the Stop TB Partnership's Global 
        Plan to End TB 2018-2022, and any follow up plan, including 
        support for--</DELETED>
                <DELETED>    ``(A) developing and using innovative new 
                technologies and therapies to increase active case 
                finding to rapidly diagnose and treat children and 
                adults with all forms of tuberculosis, alleviate 
                suffering, and ensure tuberculosis treatment 
                completion;</DELETED>
                <DELETED>    ``(B) providing diagnosis and treatment 
                with the goal of successfully treating 40,000,000 
                people with tuberculosis by 2022, including 3,500,000 
                children, and 1,500,000 people with drug-resistant 
                tuberculosis in support of the target set by the 
                Political Declaration of the High-Level Meeting of the 
                General Assembly on the Fight Against 
                Tuberculosis;</DELETED>
                <DELETED>    ``(C) diagnosing and treating latent 
                tuberculosis infection, in support of the global goal 
                of providing preventive therapy to at least 30,000,000 
                people, including 4,000,000 children under 5 years of 
                age, 20,000,000 household contacts of people affected 
                by tuberculosis, and 6,000,000 people living with HIV, 
                by 2022;</DELETED>
                <DELETED>    ``(D) ensuring high quality tuberculosis 
                care by closing gaps in care cascades, implementing 
                continuous quality improvement at all levels of care, 
                and providing patient support; and</DELETED>
                <DELETED>    ``(E) sustainably procuring tuberculosis 
                commodities to avoid interruptions in supply, the 
                procurement of commodities of unknown quality, or 
                payment of excessive commodity costs in countries 
                impacted by tuberculosis; and</DELETED>
        <DELETED>    ``(3) to ensure that United States funding 
        supports activities that simultaneously emphasize--</DELETED>
                <DELETED>    ``(A) the development of comprehensive 
                person-centered programs, including diagnosis, 
                treatment, and prevention strategies to ensure that--
                </DELETED>
                        <DELETED>    ``(i) all people sick with 
                        tuberculosis receive quality diagnosis and 
                        treatment through active case finding; 
                        and</DELETED>
                        <DELETED>    ``(ii) people at high risk for 
                        tuberculosis infection are found and treated 
                        with preventive therapies in a timely 
                        manner;</DELETED>
                <DELETED>    ``(B) robust tuberculosis infection 
                control practices are implemented in all congregate 
                settings, including hospitals and prisons;</DELETED>
                <DELETED>    ``(C) the deployment of diagnostic and 
                treatment capacity--</DELETED>
                        <DELETED>    ``(i) in areas with the highest 
                        tuberculosis burdens; and</DELETED>
                        <DELETED>    ``(ii) for highly at-risk and 
                        impoverished populations, including patient 
                        support;</DELETED>
                <DELETED>    ``(D) program monitoring and evaluation 
                based on critical tuberculosis indicators, including 
                indicators relating to infection control, the numbers 
                of patients accessing tuberculosis treatment, along 
                with patient support services, and preventative therapy 
                for those at risk, including all close contacts, and 
                treatment outcomes for all forms of 
                tuberculosis;</DELETED>
                <DELETED>    ``(E) training and engagement of health 
                care workers on the use of new diagnostic tools and 
                therapies as they become available, and increased 
                support for training frontline health care workers to 
                support expanded tuberculosis active case finding, 
                contact tracing and patient support;</DELETED>
                <DELETED>    ``(F) coordination with domestic agencies 
                and organizations on an aggressive research agenda to 
                develop vaccines as well as new tools to diagnose, 
                treat, and prevent tuberculosis globally;</DELETED>
                <DELETED>    ``(G) linkages with the private sector 
                on--</DELETED>
                        <DELETED>    ``(i) research and development of 
                        a vaccine, and on new tools for diagnosis and 
                        treatment of tuberculosis;</DELETED>
                        <DELETED>    ``(ii) improving current tools for 
                        diagnosis and treatment of tuberculosis; 
                        and</DELETED>
                        <DELETED>    ``(iii) training healthcare 
                        professionals on use of the newest and most 
                        effective diagnostic and therapeutic 
                        tools;</DELETED>
                <DELETED>    ``(H) the reduction of barriers to care, 
                including stigma and treatment and diagnosis costs, 
                through--</DELETED>
                        <DELETED>    ``(i) training for health 
                        workers;</DELETED>
                        <DELETED>    ``(ii) sensitizing of policy 
                        makers;</DELETED>
                        <DELETED>    ``(iii) requirements for access 
                        and affordability provisions in all grants and 
                        funding agreements;</DELETED>
                        <DELETED>    ``(iv) education and empowerment 
                        campaigns for tuberculosis patients regarding 
                        local tuberculosis services;</DELETED>
                        <DELETED>    ``(v) monitoring barriers to 
                        accessing tuberculosis services; and</DELETED>
                        <DELETED>    ``(vi) increased support for 
                        patient-led and community-led tuberculosis 
                        outreach efforts; and</DELETED>
                <DELETED>    ``(I) support for country-level, 
                sustainable accountability mechanisms and capacity to 
                measure progress and ensure that commitments made by 
                governments and relevant stakeholders are 
                met.</DELETED>
<DELETED>    ``(c) Definitions.--In this section:</DELETED>
        <DELETED>    ``(1) Appropriate congressional committees.--The 
        term `appropriate congressional committees' means the Committee 
        on Foreign Relations of the Senate and the Committee on Foreign 
        Affairs of the House of Representatives.</DELETED>
        <DELETED>    ``(2) End tb strategy.--The term `End TB Strategy' 
        means the strategy to eliminate tuberculosis that was approved 
        by the World Health Assembly in May 2014, and is described in 
        The End TB Strategy: Global strategy and targets for 
        tuberculosis prevention, care and control after 2015.</DELETED>
        <DELETED>    ``(3) Global alliance for tuberculosis drug 
        development.--The term `Global Alliance for Tuberculosis Drug 
        Development' means the public-private partnership that bring 
        together leaders in health, science, philanthropy, and private 
        industry to devise new approaches to tuberculosis.</DELETED>
        <DELETED>    ``(4) Global tuberculosis drug facility.--The term 
        `Global Tuberculosis Drug Facility' means the initiative of the 
        Stop Tuberculosis Partnership to increase access to the most 
        advanced, affordable, quality-assured tuberculosis drugs and 
        diagnostics.</DELETED>
        <DELETED>    ``(5) MDR-TB.--The term `MDR-TB' means multi-drug-
        resistant tuberculosis.</DELETED>
        <DELETED>    ``(6) Stop tuberculosis partnership.--The term 
        `Stop Tuberculosis Partnership' means the partnership of the 
        United Nations Office for Project Services, donors including 
        the United States, high tuberculosis burden countries, 
        multilateral agencies, and nongovernmental and technical 
        agencies committed to short- and long-term measures required to 
        control and eventually eliminate tuberculosis as a public 
        health problem in the world.</DELETED>
        <DELETED>    ``(7) XDR-TB.--The term `XDR-TB' means extensively 
        drug-resistant tuberculosis.</DELETED>
<DELETED>    ``(d) Authorization.--To carry out this section, the 
President is authorized, consistent with section 104(c), to furnish 
assistance, on such terms and conditions as the President may 
determine, for the prevention, treatment, control, and elimination of 
tuberculosis.</DELETED>
<DELETED>    ``(e) Goals.--In consultation with the appropriate 
congressional committees, the President shall establish goals, based on 
the policy and indicators described in subsection (b), for United 
States tuberculosis programs to detect, cure and prevent all forms of 
tuberculosis globally for the period between 2023 and 2030 that is 
aligned with the End TB Strategy's 2030 targets, by updating the United 
States Government Tuberculosis Strategy (2015-2019) and the National 
Action Plan for Combating Multidrug-Resistant Tuberculosis.</DELETED>
<DELETED>    ``(f) Coordination.--</DELETED>
        <DELETED>    ``(1) In general.--In carrying out this section, 
        the President shall coordinate with the World Health 
        Organization, the Stop TB Partnership, the Global Fund to Fight 
        AIDS, Tuberculosis, and Malaria, and other organizations with 
        respect to the development and implementation of a 
        comprehensive global tuberculosis response program.</DELETED>
        <DELETED>    ``(2) Bilateral assistance.--In providing 
        bilateral assistance under this section, the President, acting 
        through the Administrator of the United States Agency for 
        International Development, shall--</DELETED>
                <DELETED>    ``(A) catalyze support for research and 
                development of new tools to prevent, diagnose, treat, 
                and control tuberculosis worldwide, particularly to 
                reduce the incidence of, and mortality from, all forms 
                of drug-resistant tuberculosis;</DELETED>
                <DELETED>    ``(B) ensure United States programs and 
                activities aimed at reaching those infected with 
                tuberculosis provide quality diagnosis and treatment, 
                and reach those at high risk with preventive therapy; 
                and</DELETED>
                <DELETED>    ``(C) ensure coordination among relevant 
                United States Government agencies, including the 
                Centers for Disease Control and Prevention, the 
                National Institutes of Health, the Biomedical Advanced 
                Research and Development Authority, the Food and Drug 
                Administration, the National Science Foundation, the 
                Department of Defense (through its Congressionally 
                Directed Medical Research Program), and other Federal 
                agencies that engage in international tuberculosis 
                activities to ensure accountability and transparency, 
                reduce duplication of efforts and ensure appropriate 
                integration and coordination of tuberculosis services 
                into other United States-supported health 
                programs.</DELETED>
<DELETED>    ``(g) Priority To End TB Strategy.--In furnishing 
assistance under subsection (d), the President shall give priority to--
</DELETED>
        <DELETED>    ``(1) building and strengthening tuberculosis 
        programs to diagnose and treat all people sick with TB, and 
        ensuring everyone who is sick with tuberculosis have access to 
        quality diagnosis and treatment;</DELETED>
        <DELETED>    ``(2) direct, high-quality integrated services for 
        all forms of tuberculosis, as described by the World Health 
        Organization, which call for the coordination of active case 
        finding, treatment of all forms of tuberculosis disease and 
        infection, patient support, and tuberculosis 
        prevention;</DELETED>
        <DELETED>    ``(3) individuals co-infected with HIV and other 
        co-morbidities, and other individuals with tuberculosis who may 
        be at risk of stigma;</DELETED>
        <DELETED>    ``(4) strengthening the capacity of health systems 
        to detect, prevent, and treat tuberculosis, including MDR-TB 
        and XDR-TB, as described in the International Standards for 
        Tuberculosis Care, and the latest international guidance 
        related to tuberculosis;</DELETED>
        <DELETED>    ``(5) research and development of innovative 
        diagnostics, drug therapies, and vaccines, and program-based 
        operational research;</DELETED>
        <DELETED>    ``(6) the Stop Tuberculosis Partnership's Global 
        Drug Facility, and the Global Alliance for Tuberculosis Drug 
        Development, and other organizations promoting the development 
        of new products and drugs for tuberculosis; and</DELETED>
        <DELETED>    ``(7) ensuring tuberculosis programs can serve as 
        key platforms for supporting national respiratory pandemic 
        response against existing and new infectious respiratory 
        disease.</DELETED>
<DELETED>    ``(h) Assistance for the World Health Organization and the 
Stop Tuberculosis Partnership.--In carrying out this section, the 
President, acting through the Administrator of the United States Agency 
for International Development, is authorized to provide increased 
resources to the World Health Organization and the Stop Tuberculosis 
Partnership to improve the capacity of countries with high burdens or 
rates of tuberculosis and other affected countries to implement the End 
TB Strategy, the Stop TB Global Plan to End TB, their own national 
strategies and plans, other global efforts to control MDR-TB and XDR-
TB.</DELETED>
<DELETED>    ``(i) Annual Report on Tuberculosis Activities.--Not later 
than December 15 of each year until the goals specified in subsection 
(b)(1) are met, the President shall submit an annual report to the 
appropriate congressional committees that describes United States 
foreign assistance to control tuberculosis and the impact of such 
efforts, including--</DELETED>
        <DELETED>    ``(1) the number of individuals with active 
        tuberculosis disease that were diagnosed and treated, including 
        the rate of treatment completion and the number receiving 
        patient support;</DELETED>
        <DELETED>    ``(2) the number of persons with MDR-TB and XDR-TB 
        that were diagnosed and treated, including the rate of 
        completion, in countries receiving United States bilateral 
        foreign assistance for tuberculosis control programs;</DELETED>
        <DELETED>    ``(3) the numbers of people trained by the United 
        States Government in tuberculosis surveillance and 
        control;</DELETED>
        <DELETED>    ``(4) the number of individuals with active TB 
        disease identified as a result of engagement with the private 
        sector and other nongovernmental partners in countries 
        receiving United States bilateral foreign assistance for 
        tuberculosis control programs;</DELETED>
        <DELETED>    ``(5) a description of the collaboration and 
        coordination of United States anti-tuberculosis efforts with 
        the World Health Organization, the Stop TB Partnership, the 
        Global Fund to Fight AIDS, Tuberculosis and Malaria, and other 
        major public and private entities;</DELETED>
        <DELETED>    ``(6) a description of the collaboration and 
        coordination among the United States Agency for International 
        Development and other United States agencies, including the 
        Centers for Disease Control and Prevention and the Office of 
        the Global AIDS Coordinator, for the purposes of combating 
        tuberculosis;</DELETED>
        <DELETED>    ``(7) the constraints on implementation of 
        programs posed by health workforce shortages, health system 
        limitations, other components of successful implementation, and 
        strategies to address such constraints;</DELETED>
        <DELETED>    ``(8) a breakdown of expenditures for patient 
        services supporting TB diagnosis, treatment, and prevention, 
        including procurement of drugs and other commodities, drug 
        management, training in diagnosis and treatment, health systems 
        strengthening that directly impacts provision of TB services, 
        and research; and</DELETED>
        <DELETED>    ``(9) for each country receiving bilateral United 
        States assistance for the purpose of tuberculosis prevention, 
        treatment, and control--</DELETED>
                <DELETED>    ``(A) a description of progress to adopt 
                and implement the most recent World Health Organization 
                guidelines to improve diagnosis, treatment, and 
                prevention of tuberculosis for adults and children, 
                disaggregated by sex, including the proportion of 
                health facilities that have adopted the latest World 
                Health Organization guidelines on strengthening 
                surveillance systems and preventative, diagnostic, and 
                therapeutic methods, including the use of rapid 
                diagnostic tests and orally administered tuberculosis 
                treatment regimens;</DELETED>
                <DELETED>    ``(B) the number of adults and children 
                receiving tuberculosis preventive therapy, including 
                people with HIV and all close contacts, disaggregated 
                by sex and, as possible, income or wealth quintile, and 
                the establishment of effective tuberculosis infection 
                control in all relevant congregant settings, including 
                hospitals, clinics, and prisons;</DELETED>
                <DELETED>    ``(C) a description of progress in 
                implementing measures to reduce tuberculosis incidence, 
                including actions--</DELETED>
                        <DELETED>    ``(i) to expand active case 
                        finding and contact tracing to identify and 
                        reach vulnerable groups; and</DELETED>
                        <DELETED>    ``(ii) to expand tuberculosis 
                        preventive therapy, engagement of the private 
                        sector, and diagnostic capacity;</DELETED>
                <DELETED>    ``(D) a description of progress to expand 
                diagnosis, prevention, and treatment for all forms of 
                tuberculosis, including in pregnant women, children, 
                and other high-risk individuals and groups at greater 
                risk of TB, including migrants, prisoners, miners, 
                people exposed to silica, and people living with HIV/
                AIDS, disaggregated by sex;</DELETED>
                <DELETED>    ``(E) the rate of successful completion of 
                tuberculosis treatment for adults and children, 
                disaggregated by sex, and the number of individuals 
                receiving support for treatment completion;</DELETED>
                <DELETED>    ``(F) the number of people, disaggregated 
                by sex, receiving treatment for MDR-TB, the proportion 
                of those treated with the latest regimens endorsed by 
                the World Health Organization, any factors impeding 
                scale up of such treatment, and a description of 
                progress to expand community-based MDR-TB 
                care;</DELETED>
                <DELETED>    ``(G) a description of tuberculosis 
                commodity procurement challenges, including shortages, 
                stockouts, or failed tenders for tuberculosis drugs or 
                other commodities;</DELETED>
                <DELETED>    ``(H) the proportion of health facilities 
                with specimen referral linkages to GeneXpert testing 
                sites, and to reference labs for second line drug 
                resistance testing, and a description of the turnaround 
                time for test results;</DELETED>
                <DELETED>    ``(I) the number of people trained by the 
                United States Government to deliver high-quality 
                tuberculosis surveillance, laboratory services, 
                prevention, treatment, and care;</DELETED>
                <DELETED>    ``(J) a description of how supported 
                activities are coordinated with--</DELETED>
                        <DELETED>    ``(i) country national TB plans 
                        and strategies; and</DELETED>
                        <DELETED>    ``(ii) tuberculosis control 
                        efforts supported by the Global Fund to Fight 
                        AIDS, Tuberculosis, and Malaria, and other 
                        international assistance funds, including in 
                        the areas of program development and 
                        implementation; and</DELETED>
                <DELETED>    ``(K) for the first 3 years of the report 
                required under this subsection, a section that 
                describes the progress in recovering from the negative 
                impact of COVID-19 on tuberculosis, including whether 
                there has been the development and implementation of a 
                comprehensive plan to ensure tuberculosis activities 
                recover from diversion of resources, the continued use 
                of bidirectional TB-COVID testing, and progress on 
                increased diagnosis and treatment of active 
                tuberculosis.</DELETED>
<DELETED>    ``(j) Annual Report on Tuberculosis Research and 
Development.--The President, acting through the Administrator of the 
United States Agency for International Development, and in coordination 
with the National Institutes of Health, the Centers for Disease Control 
and Prevention, the Biomedical Advanced Research and Development 
Authority, the Food and Drug Administration, the National Science 
Foundation, and the Office of the Global AIDS Coordinator, shall submit 
an annual report to Congress that--</DELETED>
        <DELETED>    ``(1) describes current progress and challenges to 
        the development of new tools for the purpose of tuberculosis 
        prevention, treatment, and control;</DELETED>
        <DELETED>    ``(2) identifies critical gaps and emerging 
        priorities for research and development, including for rapid 
        and point-of-care diagnostics, shortened treatments and 
        prevention methods, and vaccines; and</DELETED>
        <DELETED>    ``(3) describes research investments by type, 
        funded entities, and level of investment.</DELETED>
<DELETED>    ``(k) Evaluation Report.--Not later than 2 years after the 
date of the enactment of the End Tuberculosis Now Act of 2021, and 
every 5 years thereafter until 2036, the Comptroller General of the 
United States shall submit a report to the appropriate congressional 
committees that evaluates the performance and impact on tuberculosis 
prevention, diagnosis, treatment, and care efforts that are supported 
by United States bilateral assistance funding, including 
recommendations for improving such programs.''.</DELETED>

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``End Tuberculosis Now Act of 2022''.

SEC. 2. FINDINGS.

    Congress makes the following findings:
            (1) Tuberculosis (referred to in the Act as ``TB'') is a 
        preventable, treatable, and curable disease, yet more than 25 
        years after the World Health Organization declared it to be a 
        public health emergency and called on countries to make scaling 
        up TB control a priority, TB remains a deadly health threat.
            (2) In 2021 alone, an estimated 10,600,000 people became 
        ill with TB, 11 percent of whom were children, and an estimated 
        1,600,000 of these people died from the illness. In order to 
        achieve by 2035 the goals of the Political Declaration of the 
        High-Level Meeting of the General Assembly on the Fight Against 
        Tuberculosis, adopted by the United Nations General Assembly 
        October 10, 2018, and of the World Health Organization End TB 
        Strategy, adopted by the World Health Assembly in 2014, new and 
        existing tools must be developed and scaled-up.
            (3) More than \1/3\ of people who become ill with TB may be 
        undiagnosed or misdiagnosed, resulting in unnecessary illness, 
        communicable infections, and increased mortality.
            (4) Since March 2020, the COVID-19 pandemic has severely 
        disrupted TB responses in low- and middle-income countries, 
        stalling and reversing years of progress made against TB. 
        According to the World Health Organization, from 2019 to 2020--
                    (A) global detection of TB dropped by 18 percent;
                    (B) an estimated 1,300,000 fewer people were 
                diagnosed and enrolled on TB treatment; and
                    (C) in some countries, TB case notifications 
                dropped by up to 41 percent, setting progress back by 
                up to 12 years.
            (5) Failure to properly diagnose and treat TB can lead to 
        death, can exacerbate antimicrobial resistance (a key 
        contributor to rising cases of multi-drug-resistant TB and 
        extensively drug-resistant TB), and can increase the 
        probability of the introduction of resistant TB into new 
        geographic areas.
            (6) TB programs have played a central role in responding to 
        COVID-19, including through leveraging the expertise of medical 
        staff with expertise in TB and lung diseases, the repurposing 
        of TB hospitals, and the use of the TB rapid molecular testing 
        platforms and x-ray equipment for multiple purposes, including 
        the treatment of COVID-19.
            (7) With sufficient resourcing, TB program expertise, 
        infection control, laboratory capacity, active case finding, 
        and contact investigation can serve as platforms for 
        respiratory pandemic response against existing and new 
        infectious respiratory disease without disrupting ongoing TB 
        programs and activities.
            (8) Globally, only about \1/2\ of the $13,000,000,000 
        required annually, as outlined in the Stop TB Partnership's 
        Global Plan to End TB, is currently available.
            (9) According to estimates by the Global Fund for AIDS, 
        Tuberculosis, and Malaria, an additional $3,500,000,000 was 
        needed during 2021 for TB programs in eligible countries in 
        order to recover from the negative impacts of COVID-19.
            (10) On September 26, 2018, the United Nations convened the 
        first High-Level Meeting of the General Assembly on the Fight 
        Against Tuberculosis, during which 120 countries--
                    (A) signed a Political Declaration to accelerate 
                progress against TB, including through commitments to 
                increase funding for TB prevention, diagnosis, 
                treatment, and research and development programs, and 
                to set ambitious goals to successfully treat 40,000,000 
                people with active TB and prevent at least 30,000,000 
                from becoming ill with TB between 2018 and 2022; and
                    (B) committed to ``ending the epidemic in all 
                countries, and pledge[d] to provide leadership and to 
                work together to accelerate our national and global 
                collective actions, investments and innovations 
                urgently to fight this preventable and treatable 
                disease'', as reflected in United Nations General 
                Assembly Resolution 73/3.
            (11) The United States Government continues to be a lead 
        funder of global TB research and development, contributing 44 
        percent of the total $915,000,000 in global funding in 2020, 
        and can catalyze more investments from other countries.
            (12) Working with governments and partners around the 
        world, USAID's TB programming has saved an estimated 66,000,000 
        lives, demonstrating the effectiveness of United States 
        programs and activities against the illness.
            (13) On September 26, 2018, the USAID Administrator 
        announced a new performance-based Global Accelerator to End TB, 
        aimed at catalyzing investments to meet the treatment target 
        set by the United Nations High-Level Meeting, further 
        demonstrating the critical role that United States leadership 
        and assistance plays in the fight to eliminate TB.
            (14) It is essential to ensure that efforts among United 
        States Government agencies, partner nations, international 
        organizations, nongovernmental organizations, the private 
        sector, and other actors are complementary and not duplicative 
        in order to achieve the goal of ending the TB epidemic in all 
        countries.

SEC. 3. UNITED STATES GOVERNMENT ACTIONS TO END TUBERCULOSIS.

    Section 104B of the Foreign Assistance Act of 1961 (22 U.S.C. 
2151b-3) is amended to read as follows:

``SEC. 104B. ASSISTANCE TO COMBAT TUBERCULOSIS.

    ``(a) Findings.--Congress makes the following findings:
            ``(1) The international spread of tuberculosis (referred to 
        in this section as `TB') and the deadly impact of TB's 
        continued existence constitutes a continuing challenge.
            ``(2) Additional tools and resources are required to 
        effectively diagnose, prevent, and treat TB.
            ``(3) Effectively resourced TB programs can serve as a 
        critical platform for preventing and responding to future 
        infectious respiratory disease pandemics.
    ``(b) Policy.--
            ``(1) In general.--It is a major objective of the foreign 
        assistance program of the United States to help end the TB 
        public health emergency through accelerated actions--
                    ``(A) to support the diagnosis and treatment of all 
                adults and children with all forms of TB; and
                    ``(B) to prevent new TB infections from occurring.
            ``(2) Support for global plans and objectives.--In 
        countries in which the United States Government has established 
        foreign assistance programs under this Act, particularly in 
        countries with the highest burden of TB and other countries 
        with high rates of infection and transmission of TB, it is the 
        policy of the United States--
                    ``(A) to support the objectives of the World Health 
                Organization End TB Strategy, including its goals--
                            ``(i) to reduce TB deaths by 95 percent by 
                        2035;
                            ``(ii) to reduce the TB incidence rate by 
                        90 percent by 2035; and
                            ``(iii) to reduce the number of families 
                        facing catastrophic health costs due to TB by 
                        100 percent by 2035;
                    ``(B) to support the Stop TB Partnership's Global 
                Plan to End TB 2023-2030, including by providing 
                support for--
                            ``(i) developing and using innovative new 
                        technologies and therapies to increase active 
                        case finding and rapidly diagnose and treat 
                        children and adults with all forms of TB, 
                        alleviate suffering, and ensure TB treatment 
                        completion;
                            ``(ii) expanding diagnosis and treatment in 
                        line with the goals established by the 
                        Political Declaration of the High-Level Meeting 
                        of the General Assembly on the Fight Against 
                        Tuberculosis, including--
                                    ``(I) successfully treating 
                                40,000,000 people with active TB by 
                                2023, including 3,500,000 children, and 
                                1,500,000 people with drug-resistant 
                                TB; and
                                    ``(II) diagnosing and treating 
                                latent tuberculosis infection, in 
                                support of the global goal of providing 
                                preventive therapy to at least 
                                30,000,000 people by 2023, including 
                                4,000,000 children younger than 5 years 
                                of age, 20,000,000 household contacts 
                                of people affected by TB, and 6,000,000 
                                people living with HIV;
                            ``(iii) ensuring high-quality TB care by 
                        closing gaps in care cascades, implementing 
                        continuous quality improvement at all levels of 
                        care, and providing related patient support; 
                        and
                            ``(iv) sustainable procurements of TB 
                        commodities to avoid interruptions in supply, 
                        the procurement of commodities of unknown 
                        quality, or payment of excessive commodity 
                        costs in countries impacted by TB;
                    ``(C) ensure, to the greatest extent practicable, 
                that United States funding supports activities that 
                simultaneously emphasize--
                            ``(i) the development of comprehensive 
                        person-centered programs, including diagnosis, 
                        treatment, and prevention strategies to ensure 
                        that--
                                    ``(I) all people sick with TB 
                                receive quality diagnosis and treatment 
                                through active case finding; and
                                    ``(II) people at high risk for TB 
                                infection are found and treated with 
                                preventive therapies in a timely 
                                manner;
                            ``(ii) robust TB infection control 
                        practices are implemented in all congregate 
                        settings, including hospitals and prisons;
                            ``(iii) the deployment of diagnostic and 
                        treatment capacity--
                                    ``(I) in areas with the highest TB 
                                burdens; and
                                    ``(II) for highly at-risk and 
                                impoverished populations, including 
                                patient support services;
                            ``(iv) program monitoring and evaluation 
                        based on critical TB indicators, including 
                        indicators relating to infection control, the 
                        numbers of patients accessing TB treatment and 
                        patient support services, and preventative 
                        therapy for those at risk, including all close 
                        contacts, and treatment outcomes for all forms 
                        of TB;
                            ``(v) training and engagement of health 
                        care workers on the use of new diagnostic tools 
                        and therapies as they become available, and 
                        increased support for training frontline health 
                        care workers to support expanded TB active case 
                        finding, contact tracing, and patient support 
                        services;
                            ``(vi) coordination with domestic agencies 
                        and organizations to support an aggressive 
                        research agenda to develop vaccines as well as 
                        new tools to diagnose, treat, and prevent TB 
                        globally;
                            ``(vii) linkages with the private sector 
                        on--
                                    ``(I) research and development of a 
                                vaccine, and on new tools for diagnosis 
                                and treatment of TB;
                                    ``(II) improving current tools for 
                                diagnosis and treatment of TB, 
                                including telehealth solutions for 
                                prevention and treatment; and
                                    ``(III) training healthcare 
                                professionals on use of the newest and 
                                most effective diagnostic and 
                                therapeutic tools;
                            ``(viii) the reduction of barriers to care, 
                        including stigma and treatment and diagnosis 
                        costs, including through--
                                    ``(I) training health workers;
                                    ``(II) sensitizing policy makers;
                                    ``(III) requiring that all relevant 
                                grants and funding agreements include 
                                access and affordability provisions;
                                    ``(IV) supporting education and 
                                empowerment campaigns for TB patients 
                                regarding local TB services;
                                    ``(V) monitoring barriers to 
                                accessing TB services; and
                                    ``(VI) increasing support for 
                                patient-led and community-led TB 
                                outreach efforts; and
                            ``(ix) support for country-level, 
                        sustainable accountability mechanisms and 
                        capacity to measure progress and ensure that 
                        commitments made by governments and relevant 
                        stakeholders are met.
    ``(c) Definitions.--In this section:
            ``(1) Appropriate congressional committees.--The term 
        `appropriate congressional committees' means the Committee on 
        Foreign Relations of the Senate and the Committee on Foreign 
        Affairs of the House of Representatives.
            ``(2) End tb strategy.--The term `End TB Strategy' means 
        the strategy to eliminate TB that was approved by the World 
        Health Assembly in May 2014, and is described in `The End TB 
        Strategy: Global Strategy and Targets for Tuberculosis 
        Prevention, Care and Control After 2015'.
            ``(3) Global alliance for tuberculosis drug development.--
        The term `Global Alliance for Tuberculosis Drug Development' 
        means the public-private partnership that bring together 
        leaders in health, science, philanthropy, and private industry 
        to devise new approaches to TB.
            ``(4) Global tuberculosis drug facility.--The term `Global 
        Tuberculosis Drug Facility' means the initiative of the Stop 
        Tuberculosis Partnership to increase access to the most 
        advanced, affordable, quality-assured TB drugs and diagnostics.
            ``(5) MDR-TB.--The term `MDR-TB' means multi-drug-resistant 
        TB.
            ``(6) Stop tuberculosis partnership.--The term `Stop 
        Tuberculosis Partnership' means the partnership of 1,600 
        organizations (including international and technical 
        organizations, government programs, research and funding 
        agencies, foundations, nongovernmental organizations, civil 
        society and community groups, and the private sector), donors, 
        including the United States, high TB burden countries, 
        multilateral agencies, and nongovernmental and technical 
        agencies, which is governed by the Stop TB Partnership 
        Coordinating Board and hosted by a United Nations entity, 
        committed to short- and long-term measures required to control 
        and eventually eliminate TB as a public health problem in the 
        world.
            ``(7) XDR-TB.--The term `XDR-TB' means extensively drug-
        resistant TB.
    ``(d) Authorization.--To carry out this section, the President is 
authorized, consistent with section 104(c), to furnish assistance, on 
such terms and conditions as the President may determine, for the 
prevention, treatment, control, and elimination of TB.
    ``(e) Goals.--In consultation with the appropriate congressional 
committees, the President shall establish goals, based on the policy 
and indicators described in subsection (b), for--
            ``(1) United States TB programs to detect, cure, and 
        prevent all forms of TB globally for the period between 2023 
        and 2030 that are aligned with the End TB Strategy's 2030 
        targets and the USAID's Global Tuberculosis (TB) Strategy 2023-
        2030; and
            ``(2) updating the National Action Plan for Combating 
        Multidrug-Resistant Tuberculosis.
    ``(f) Coordination.--
            ``(1) In general.--In carrying out this section, the 
        President shall coordinate with the World Health Organization, 
        the Stop TB Partnership, the Global Fund to Fight AIDS, 
        Tuberculosis, and Malaria, and other organizations with respect 
        to the development and implementation of a comprehensive global 
        TB response program.
            ``(2) Bilateral assistance.--In providing bilateral 
        assistance under this section, the President, acting through 
        the Administrator of the United States Agency for International 
        Development, shall--
                    ``(A) catalyze support for research and development 
                of new tools to prevent, diagnose, treat, and control 
                TB worldwide, particularly to reduce the incidence of, 
                and mortality from, all forms of drug-resistant TB;
                    ``(B) ensure United States programs and activities 
                focus on finding individuals with active TB disease and 
                provide quality diagnosis and treatment, including 
                through digital health solutions, and reaching those at 
                high risk with preventive therapy; and
                    ``(C) ensure coordination among relevant United 
                States Government agencies, including the Department of 
                State, the Centers for Disease Control and Prevention, 
                the National Institutes of Health, the Biomedical 
                Advanced Research and Development Authority, the Food 
                and Drug Administration, the National Science 
                Foundation, the Department of Defense (through its 
                Congressionally Directed Medical Research Programs), 
                and other relevant Federal departments and agencies 
                that engage in international TB activities--
                            ``(i) to ensure accountability and 
                        transparency;
                            ``(ii) to reduce duplication of efforts; 
                        and
                            ``(iii) to ensure appropriate integration 
                        and coordination of TB services into other 
                        United States-supported health programs.
    ``(g) Priority To End TB Strategy.--In furnishing assistance under 
subsection (d), the President shall prioritize--
            ``(1) building and strengthening TB programs--
                    ``(A) to increase the diagnosis and treatment of 
                everyone who is sick with TB; and
                    ``(B) to ensure that such individuals have access 
                to quality diagnosis and treatment;
            ``(2) direct, high-quality integrated services for all 
        forms of TB, as described by the World Health Organization, 
        which call for the coordination of active case finding, 
        treatment of all forms of TB disease and infection, patient 
        support, and TB prevention;
            ``(3) treating individuals co-infected with HIV and other 
        co-morbidities, and other individuals with TB who may be at 
        risk of stigma;
            ``(4) strengthening the capacity of health systems to 
        detect, prevent, and treat TB, including MDR-TB and XDR-TB, as 
        described in the latest international guidance related to TB;
            ``(5) researching and developing innovative diagnostics, 
        drug therapies, and vaccines, and program-based research;
            ``(6) support for the Stop Tuberculosis Partnership's 
        Global Drug Facility, the Global Alliance for Tuberculosis Drug 
        Development, and other organizations promoting the development 
        of new products and drugs for TB; and
            ``(7) ensuring that TB programs can serve as key platforms 
        for supporting national respiratory pandemic response against 
        existing and new infectious respiratory disease.
    ``(h) Assistance for the World Health Organization and the Stop 
Tuberculosis Partnership.--In carrying out this section, the President, 
acting through the Administrator of the United States Agency for 
International Development, is authorized--
            ``(1) to provide resources to the World Health Organization 
        and the Stop Tuberculosis Partnership to improve the capacity 
        of countries with high burdens or rates of TB and other 
        affected countries to implement the End TB Strategy, the Stop 
        TB Global Plan to End TB, their own national strategies and 
        plans, other global efforts to control MDR-TB and XDR-TB; and
            ``(2) to leverage the contributions of other donors for the 
        activities described in paragraph (1).
    ``(i) Annual Report on TB Activities.--Not later than December 15 
of each year until the earlier of the date on which the goals specified 
in subsection (b)(2)(A) are met or the last day of 2035, the President 
shall submit an annual report to the appropriate congressional 
committees that describes United States foreign assistance to control 
TB and the impact of such efforts, including--
            ``(1) the number of individuals with active TB disease that 
        were diagnosed and treated, including the rate of treatment 
        completion and the number receiving patient support;
            ``(2) the number of persons with MDR-TB and XDR-TB that 
        were diagnosed and treated, including the rate of completion, 
        in countries receiving United States bilateral foreign 
        assistance for TB control programs;
            ``(3) the number of people trained by the United States 
        Government in TB surveillance and control;
            ``(4) the number of individuals with active TB disease 
        identified as a result of engagement with the private sector 
        and other nongovernmental partners in countries receiving 
        United States bilateral foreign assistance for TB control 
        programs;
            ``(5) a description of the collaboration and coordination 
        of United States anti-TB efforts with the World Health 
        Organization, the Stop TB Partnership, the Global Fund to Fight 
        AIDS, Tuberculosis and Malaria, and other major public and 
        private entities;
            ``(6) a description of the collaboration and coordination 
        among the United States Agency for International Development 
        and other United States departments and agencies, including the 
        Centers for Disease Control and Prevention and the Office of 
        the Global AIDS Coordinator, for the purposes of combating TB;
            ``(7) the constraints on implementation of programs posed 
        by health workforce shortages, health system limitations, 
        barriers to digital health implementation, other challenges to 
        successful implementation, and strategies to address such 
        constraints;
            ``(8) a breakdown of expenditures for patient services 
        supporting TB diagnosis, treatment, and prevention, including 
        procurement of drugs and other commodities, drug management, 
        training in diagnosis and treatment, health systems 
        strengthening that directly impacts the provision of TB 
        services, and research; and
            ``(9) for each country, and when practicable, each project 
        site receiving bilateral United States assistance for the 
        purpose of TB prevention, treatment, and control--
                    ``(A) a description of progress toward the adoption 
                and implementation of the most recent World Health 
                Organization guidelines to improve diagnosis, 
                treatment, and prevention of TB for adults and 
                children, disaggregated by sex, including the 
                proportion of health facilities that have adopted the 
                latest World Health Organization guidelines on 
                strengthening monitoring systems and preventative, 
                diagnostic, and therapeutic methods, including the use 
                of rapid diagnostic tests and orally administered TB 
                treatment regimens;
                    ``(B) the number of individuals screened for TB 
                disease and the number evaluated for TB infection using 
                active case finding outside of health facilities;
                    ``(C) the number of individuals with active TB 
                disease that were diagnosed and treated, including the 
                rate of treatment completion and the number receiving 
                patient support;
                    ``(D) the number of adults and children, including 
                people with HIV and close contacts, who are evaluated 
                for TB infection, the number of adults and children 
                started on treatment for TB infection, and the number 
                of adults and children completing such treatment, 
                disaggregated by sex and, as possible, income or wealth 
                quintile;
                    ``(E) the establishment of effective TB infection 
                control in all relevant congregant settings, including 
                hospitals, clinics, and prisons;
                    ``(F) a description of progress in implementing 
                measures to reduce TB incidence, including actions--
                            ``(i) to expand active case finding and 
                        contact tracing to reach vulnerable groups; and
                            ``(ii) to expand TB preventive therapy, 
                        engagement of the private sector, and 
                        diagnostic capacity;
                    ``(G) a description of progress to expand 
                diagnosis, prevention, and treatment for all forms of 
                TB, including in pregnant women, children, and 
                individuals and groups at greater risk of TB, including 
                migrants, prisoners, miners, people exposed to silica, 
                and people living with HIV/AIDS, disaggregated by sex;
                    ``(H) the rate of successful completion of TB 
                treatment for adults and children, disaggregated by 
                sex, and the number of individuals receiving support 
                for treatment completion;
                    ``(I) the number of people, disaggregated by sex, 
                receiving treatment for MDR-TB, the proportion of those 
                treated with the latest regimens endorsed by the World 
                Health Organization, factors impeding scale up of such 
                treatment, and a description of progress to expand 
                community-based MDR-TB care;
                    ``(J) a description of TB commodity procurement 
                challenges, including shortages, stockouts, or failed 
                tenders for TB drugs or other commodities;
                    ``(K) the proportion of health facilities with 
                specimen referral linkages to quality diagnostic 
                networks, including established testing sites and 
                reference labs, to ensure maximum access and referral 
                for second line drug resistance testing, and a 
                description of the turnaround time for test results;
                    ``(L) the number of people trained by the United 
                States Government to deliver high-quality TB 
                diagnostic, preventative, monitoring, treatment, and 
                care services;
                    ``(M) a description of how supported activities are 
                coordinated with--
                            ``(i) country national TB plans and 
                        strategies; and
                            ``(ii) TB control efforts supported by the 
                        Global Fund to Fight AIDS, Tuberculosis, and 
                        Malaria, and other international assistance 
                        programs and funds, including in the areas of 
                        program development and implementation; and
                    ``(N) for the first 3 years of the report required 
                under this subsection, a description of the progress in 
                recovering from the negative impact of COVID-19 on TB, 
                including--
                            ``(i) whether there has been the 
                        development and implementation of a 
                        comprehensive plan to recover TB activities 
                        from diversion of resources;
                            ``(ii) the continued use of bidirectional 
                        TB-COVID testing; and
                            ``(iii) progress on increased diagnosis and 
                        treatment of active TB.
    ``(j) Annual Report on TB Research and Development.--The President, 
acting through the Administrator of the United States Agency for 
International Development, and in coordination with the National 
Institutes of Health, the Centers for Disease Control and Prevention, 
the Biomedical Advanced Research and Development Authority, the Food 
and Drug Administration, the National Science Foundation, and the 
Office of the Global AIDS Coordinator, shall submit an annual report to 
the appropriate congressional committees that--
            ``(1) describes the current progress and challenges to the 
        development of new tools for the purpose of TB prevention, 
        treatment, and control;
            ``(2) identifies critical gaps and emerging priorities for 
        research and development, including for rapid and point-of-care 
        diagnostics, shortened treatments and prevention methods, 
        telehealth solutions for prevention and treatment, and 
        vaccines; and
            ``(3) describes research investments by type, funded 
        entities, and level of investment.
    ``(k) Evaluation Report.--Not later than 2 years after the date of 
the enactment of the End Tuberculosis Now Act of 2022, and every 5 
years thereafter until the last day of 2035, the Comptroller General of 
the United States shall submit a report to the appropriate 
congressional committees that evaluates the performance and impact on 
TB prevention, diagnosis, treatment, and care efforts that are 
supported by United States bilateral assistance funding, including 
recommendations for improving such programs.''.
                                                       Calendar No. 601

117th CONGRESS

  2d Session

                                S. 3386

_______________________________________________________________________

                                 A BILL

           To prevent, treat, and cure tuberculosis globally.

_______________________________________________________________________

                            December 7, 2022

                       Reported with an amendment
```